Issues in the Care and Treatment of HCV/HIV Co-Infection for Key Populations in Resource-Constrained Settings

Globally, the epidemic of hepatitis virus infection is increasing in the context of common viral transmission routes with the Human Immunodeficiency Virus (HIV). Thus, co-infection with both hepatitis virus and HIV is becoming a common occurrence, particularly for key populations. Studies of key populations, people who inject drugs, sex workers, transgendered individuals and men having sex with men, report high levels of illicit drug and/or alcohol use along with limited access to health care and medical treatment. Without the medical management of co-occurring substance use disorders and hepatitis C virus (HCV) infection, a significant proportion of this population with HCV/HIV co-infection will progress to chronic liver disease then subsequently end-stage liver disease. Thus, access to comprehensive care and treatment, including HCV testing with subsequent care and treatment of acute/chronic HCV infection is essential to address the global burden of disease. Increased efforts are needed globally to address the barriers to comprehensive care and treatment for key populations with HCV/HIV co-infection.