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Title: Favorable response in a Spanish cohort of HIV infected men with acute hepatitis C infection who received delayed antiviral treatment
Running head: Delayed treatment for acute HCV in HIV+ Men
Authors: Montoya-Ferrer A1,2*, Gorgolas M2, Garcia-Delgado R3, Fierer DS4, Fernandez-Guerrero ML2
1Division of Infectious Diseases, Montpellier University Hospital, 
80 av Augustin Fliche - 34295 Montpellier, France
2Division of Infectious Diseases, Fundacion Jimenez Diaz Hospital, Avenida Reyes Catolicos 2, Madrid 28040, Spain 
3Division of Immunology, Fundacion Jimenez Diaz Hospital, Avenida Reyes Catolicos 2, Madrid 28040, Spain 
4Division of Infectious Diseases, Department of Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1009, New York, NY 10029, USA
*Corresponding author details: 
Montoya-Ferrer Ana
D�partement des Maladies Infectieuses et Tropicales
H�pital Gui de Chauliac - CHRU de Montpellier
80 av Augustin Fliche - 34295 Montpellier Cedex 5
Tlf number: 0033647788079


 HYPERLINK "mailto:amoferro@gmail.com" amoferro@gmail.com
 HYPERLINK "mailto:a-montoyaferrer@chu-montpellier.fr/"a-montoyaferrer@chu-montpellier.fr 








































Abstract
Background: Early combined therapy within 12 weeks of diagnosis with pegylated interferon (peg-IFN) and ribavirin (RBV) for a period of 24-48 weeks is the recommended treatment for acute hepatitis C (HCV) infection in HIV-infected patients. However, scarce data are available about efficacy of the shorter 24-week regimens in cases of delayed initiation of treatment. We describe here our outcomes among a small cohort of HIV-infected men with acute HCV infection who started treatment significantly beyond 12 weeks of acute HCV diagnosis.
Methods: HIV-infected men with acute HCV infection were treated with peg-IFN+RBV using a response-guided therapy algorithm where those achieving rapid virologic response (RVR) received 24 weeks of total therapy and those achieving complete early virologic response (cEVR) received therapy extended 20 weeks beyond their first undetectable HCV viral load (VL). 
Results: Six HIV-infected men diagnosed with acute HCV infection initiated treatment 16 to 60 weeks after acute HCV infection diagnosis.  Three had RVR and were treated for 24 weeks.  One with RVR had rebound viremia at week 12 and was treated for 48 weeks.  Two without RVR had cEVR and were treated for 28-32 weeks.  All 6 men had a sustained virologic response (SVR).
Conclusions: Despite significantly delayed initiation of treatment, all of our patients had SVR, most after receiving shorter treatment courses.  Shorter courses according to response-guided therapy might therefore be safely recommended for these patients. 

Key words: acute hepatitis C infection, duration, early treatment, HIV, men who have sex with men























Introduction
The epidemic of acute hepatitis C (HCV) infection is increasing due to risk-taking sexual behavior among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) in western countries  ADDIN EN.CITE <EndNote><Cite><Year>2011</Year><RecNum>8</RecNum><DisplayText>[1]</DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>European AIDS Treatment Network (NEAT) </author></authors></contributors><titles><title>Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference</title><secondary-title>AIDS</secondary-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><pages>399-409</pages><volume>25</volume><number>4</number><edition>2010/12/09</edition><keywords><keyword>AIDS-Related Opportunistic Infections/classification/ diagnosis/epidemiology</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>HIV Infections/complications/epidemiology</keyword><keyword>Hepatitis C/complications/ diagnosis/epidemiology/ therapy</keyword><keyword>Humans</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb 20</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21139491</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e328343443b</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1]. Acute HCV infection has important implications for HIV-infected patients, due to an increased risk of HCV chronicity and the possibility of rapid development of liver cirrhosis  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_2" \o "Thein, 2008 #21" 2,  HYPERLINK \l "_ENREF_3" \o "Fierer, 2013 #13" 3]. Currently recommended treatment of acute HCV infection with pegylated interferon (peg-IFN) plus ribavirin (RBV) in HIV-infected patients within 12 weeks of diagnosis allows treatment courses of half the duration with up to three-fold higher cure rates than treatment during the chronic phase of HCV infection  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1,  HYPERLINK \l "_ENREF_4" \o "Dominguez, 2006 #31" 4-8]. However, therapy duration still remains a subject of discussion  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1,  HYPERLINK \l "_ENREF_5" \o "Lambers, 2011 #33" 5,  HYPERLINK \l "_ENREF_9" \o "Vogel, 2010 #9" 9] and few data are available regarding efficacy of shorter 24-week regimens in cases of treatment initiation delayed significantly beyond 12 weeks from diagnosis. We describe here our experience using response-guided therapy in 6 HIV-infected MSM with acute HCV infection in whom treatment onset was delayed. 
Materials and methods
This is a descriptive cohort study of 6 HIV-infected men with acute HCV infection who were diagnosed and treated between May 2010 and December 2012 in the Infectious Disease Department at Fundacion Jimenez Diaz Hospital, in Madrid. Only the patients that received delayed treatment were included. Clinical data including demographics, HIV status, sexual behavior and recent sexual transmitted infections (STI) were collected. 
When previous anti-HCV IgG status was not available, diagnosis of acute HCV infection was based on four criteria: i) newly elevated liver aminotransferase levels; ii) detectable HCV RNA; iii) positive HCV antibodies; and iv) ruling out other causes of liver disease  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1,  HYPERLINK \l "_ENREF_10" \o "Arends, 2011 #6" 10]. HCV VL was measured using Abbott Real Time PCR HCV (lower limit of detection 15 IU/mL). For HCV antibody screening we used Bayer Centaur HCV assay/Abbott architect HCV assay. Positive results were confirmed by Lia-HCV Innogenetics. We determined the HCV genotype using the VERSANT� HCV Genotype 2.0 Assay (Siemens).
Treatment with peg-IFN alpha 2a (peg-IFN� 2a) at standard doses (180 �g/week) plus RBV weight-based dosing (1000 mg if weight <75 kg or 1200 mg if weight >75 kg) was adjusted using a response-guided therapy algorithm. Patients who achieved rapid virologic response (RVR: HCV VL <15 IU/mL at week�4 of treatment) received a 24-week treatment course; patients who achieved a complete EVR (cEVR: HCV VL <15 IU/mL at week�12 of treatment) had therapy extended 20 weeks beyond their first undetectable HCV VL; patients who achieved only an EVR (e" 2 log10 IU/mL drop in VL 12 weeks after starting treatment) received a 48-week treatment course.  Sustained virologic response (SVR) was defined as HCV VL < 15 IU/mL at least 24 weeks after completing treatment.  
Antiretroviral therapy (ART) was maintained during acute HCV treatment. 
Results
Six HIV-infected MSM were diagnosed with acute HCV infection after routinely follow-up lab tests in which elevated aminotransferases levels were found. The mean age was 35 years (range 30�42). Five were infected with genotype 4 and one with genotype 1a (Table�1). Five of the six had engaged in risk-taking sexual practices; 5 had either syphilis or lymphogranuloma venereum in the prior 6�months; 3 reported having sex with MSM from other European countries, either while in Spain or abroad themselves.  At acute HCV diagnosis, all six patients had well-controlled HIV infection on ART with CD4 count >300 cells/mL and undetectable HIV VL.  Median time from diagnosis to treatment was 28 weeks (range: 16-60) (Table�1). Delay in treatment onset was mainly due to irregular attendance by the patients and late consultation by the specialists.  The 4�patients with RVR had SVR; three were treated for 24 weeks total, and one who had rebound viremia at week 12 was treated for a total of 48 weeks.  Both patients who did not have RVR but had cEVR had SVR; they achieved undetectable VL by week 8 and by week 12 and were therefore treated for a total of 28 and 32 weeks, respectively (Table 1).  Overall, tolerance to peg-IFN and RBV was good, with minor symptoms that did not require dosage adjustment or discontinuation of therapy.
Conclusion
We present here our experience treating acute HCV infection in 6 HIV-infected men who all successfully achieved SVR despite significant delay in initiation of therapy to up to 60 weeks after acute HCV diagnosis. Our favorable results likely reflect the high rates of RVR and cEVR, which are known predictors of SVR in both chronic and acute HCV infection  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1,  HYPERLINK \l "_ENREF_9" \o "Vogel, 2010 #9" 9-11] but remarkable in these cases due to the delay in therapy initiation. 
Although early treatment (i.e. after waiting just 12�weeks after diagnosis) of acute HCV is considered the standard of care as it has been associated with the highest cure rates  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_5" \o "Lambers, 2011 #33" 5,  HYPERLINK \l "_ENREF_9" \o "Vogel, 2010 #9" 9-11] some studies of acute HCV infection of HIV-infected patients report favorable responses with delays from 12 to 24 weeks.  The Australian Trial in Acute HCV did not show significantly reduced rates of SVR in those treated with early chronic infection (6-18 months) versus those with acute HCV infection (<6 months), although they calculated the time of infection from the midpoint from the last negative HCV test, which overestimates the time of infection  ADDIN EN.CITE  ADDIN EN.CITE.DATA [ HYPERLINK \l "_ENREF_12" \o "Matthews, 2009 #32" 12]. A recent retrospective study made by Lambers et al (2011) showed that delayed treatment onset (starting 24 weeks after the diagnosis of acute HCV infection) did not change SVR rates, although the number of patients with delayed treatment was also small  ADDIN EN.CITE <EndNote><Cite><Author>Lambers</Author><Year>2011</Year><RecNum>33</RecNum><DisplayText>[5]</DisplayText><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">33</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lambers, F. A.</author><author>Brinkman, K.</author><author>Schinkel, J.</author><author>Spijkerman, I. J.</author><author>Molenkamp, R.</author><author>Coutinho, R. A.</author><author>Prins, M.</author><author>van der Meer, J. T.</author></authors></contributors><auth-address>Department of Research, Public Health Service of Amsterdam, Cluster of Infectious Diseases, The Netherlands.</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration</title><secondary-title>AIDS</secondary-title><alt-title>AIDS (London, England)</alt-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><alt-periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></alt-periodical><pages>1333-6</pages><volume>25</volume><number>10</number><edition>2011/04/26</edition><keywords><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Drug Administration Schedule</keyword><keyword>HIV Infections/ complications/drug therapy</keyword><keyword>Hepatitis C/ drug therapy</keyword><keyword>Hepatitis C Antibodies/ drug effects</keyword><keyword>Homosexuality, Male</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Viral Load/ drug effects</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun 19</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21516025</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e3283480144</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_5" \o "Lambers, 2011 #33" 5]. In our cohort, 5 out 6 patients started treatment at least 28 weeks after the initial diagnosis (two > 52 weeks); the shortest time to treatment was 16 weeks after diagnosis. 
In addition, the optimal duration of therapy is still controversial due to the lack of randomized prospective studies. According to NEAT recommendations, 24 weeks of therapy is recommended for patients who achieve RVR (level AII) and extension of therapy to a full 48 weeks is recommended for patients who don�t have a RVR (level BIII)  ADDIN EN.CITE <EndNote><Cite><Author>(NEAT)</Author><Year>2011</Year><RecNum>8</RecNum><DisplayText>[1]</DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>European AIDS Treatment Network (NEAT) </author></authors></contributors><titles><title>Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference</title><secondary-title>AIDS</secondary-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><pages>399-409</pages><volume>25</volume><number>4</number><edition>2010/12/09</edition><keywords><keyword>AIDS-Related Opportunistic Infections/classification/ diagnosis/epidemiology</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>HIV Infections/complications/epidemiology</keyword><keyword>Hepatitis C/complications/ diagnosis/epidemiology/ therapy</keyword><keyword>Humans</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb 20</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21139491</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e328343443b</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_1" \o "(NEAT), 2011 #8" 1]. However, in the cohort of Lambers, no difference was found between 24 and 48 weeks treatment courses  ADDIN EN.CITE <EndNote><Cite><Author>Lambers</Author><Year>2011</Year><RecNum>33</RecNum><DisplayText>[5]</DisplayText><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">33</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lambers, F. A.</author><author>Brinkman, K.</author><author>Schinkel, J.</author><author>Spijkerman, I. J.</author><author>Molenkamp, R.</author><author>Coutinho, R. A.</author><author>Prins, M.</author><author>van der Meer, J. T.</author></authors></contributors><auth-address>Department of Research, Public Health Service of Amsterdam, Cluster of Infectious Diseases, The Netherlands.</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration</title><secondary-title>AIDS</secondary-title><alt-title>AIDS (London, England)</alt-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><alt-periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></alt-periodical><pages>1333-6</pages><volume>25</volume><number>10</number><edition>2011/04/26</edition><keywords><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Drug Administration Schedule</keyword><keyword>HIV Infections/ complications/drug therapy</keyword><keyword>Hepatitis C/ drug therapy</keyword><keyword>Hepatitis C Antibodies/ drug effects</keyword><keyword>Homosexuality, Male</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Viral Load/ drug effects</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun 19</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21516025</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e3283480144</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_5" \o "Lambers, 2011 #33" 5]. As highlighted by Vogel et al, not only negative HCV VL at week 4 or week 12 is important, but also the rate of decline of HCV VL from baseline. In 2011, The Dutch Society for HIV Physicians recommended 24 weeks treatment regimen for those patients achieving RVR or showing a fast decline of HCV VL (>2 log10 drop at week 4) and cEVR  ADDIN EN.CITE <EndNote><Cite><Author>Arends</Author><Year>2011</Year><RecNum>6</RecNum><DisplayText>[10]</DisplayText><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">6</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arends, J. E.</author><author>Lambers, F. A.</author><author>van der Meer, J. T.</author><author>Schreij, G.</author><author>Richter, C.</author><author>Brinkman, K.</author><author>Hoepelman, A. I.</author><author>The Netherlands Society for, Aids Physicians-Nvab</author></authors></contributors><auth-address>Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands. J.E.Arends@umcutrecht.nl</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV+ patients: Dutch recommendations for management</title><secondary-title>Neth J Med</secondary-title></titles><pages>43-9</pages><volume>69</volume><number>1</number><edition>2011/02/18</edition><keywords><keyword>Acute Disease</keyword><keyword>Anti-HIV Agents/ therapeutic use</keyword><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Evidence-Based Medicine</keyword><keyword>HIV Infections/ drug therapy/epidemiology</keyword><keyword>Hepatitis C/ drug therapy/epidemiology</keyword><keyword>Humans</keyword><keyword>Netherlands</keyword><keyword>Practice Guidelines as Topic</keyword><keyword>Societies, Medical</keyword><keyword>Time Factors</keyword></keywords><dates><year>2011</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1872-9061 (Electronic)&#xD;0300-2977 (Linking)</isbn><accession-num>21325703</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_10" \o "Arends, 2011 #6" 10]. Current information provided by a sub-analysis of the European Collaborative Cohort Study show 96% SVR rate when treatment was continued for 20 weeks or longer after the first undetectable VL (( 600 IU/mL) and only 20% SVR rate when treatment was continued for less than 20 weeks  ADDIN EN.CITE <EndNote><Cite><Author>Boesecke</Author><Year>2012</Year><RecNum>7</RecNum><DisplayText>[11]</DisplayText><record><rec-number>7</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">7</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Boesecke, C.</author><author>Rockstroh, J. K.</author></authors></contributors><auth-address>Department of Internal Medicine I, University of Bonn, Bonn, Germany.</auth-address><titles><title>Acute hepatitis C in patients with HIV</title><secondary-title>Semin Liver Dis</secondary-title></titles><pages>130-7</pages><volume>32</volume><number>2</number><edition>2012/07/05</edition><keywords><keyword>Antiviral Agents/ administration &amp; dosage</keyword><keyword>Australia/epidemiology</keyword><keyword>Coinfection/diagnosis/ drug therapy/epidemiology</keyword><keyword>Europe/epidemiology</keyword><keyword>Female</keyword><keyword>HIV Infections/ complications/epidemiology</keyword><keyword>Hepatitis C/diagnosis/ drug therapy/epidemiology</keyword><keyword>Humans</keyword><keyword>Interferons/ administration &amp; dosage</keyword><keyword>Male</keyword><keyword>Ribavirin/ administration &amp; dosage</keyword><keyword>United States/epidemiology</keyword></keywords><dates><year>2012</year><pub-dates><date>May</date></pub-dates></dates><isbn>1098-8971 (Electronic)&#xD;0272-8087 (Linking)</isbn><accession-num>22760652</accession-num><urls></urls><electronic-resource-num>10.1055/s-0032-1316468</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>[ HYPERLINK \l "_ENREF_11" \o "Boesecke, 2012 #7" 11]. We used this latter approach to response-guided therapy in our 2 patients who didn�t have RVR, saving them 16 to 20 weeks of treatment. Remarkably, we were also able to cure the patient who had an unexpected rebound at week 12 by treating for only an additional 36 weeks. 
In conclusion, despite delayed initiation of treatment significantly beyond what is typically considered the duration of acute HCV infection, our patients retained the early treatment advantage characteristic of acute HCV infection. These results lend further evidence that acute HCV infection is better defined as a composite of biological factors that includes enhanced treatment response rather than simply as the first 6�months of infection. The arrival of new direct-acting antiviral agents (DAA) will greatly impact treatment modalities and durations for HCV infection in the coming years. However given the high cost of these therapies, classic treatment with peg-IFN+RBV likely remain the first option for na�ve acute HCV patients coinfected with HIV in many countries. Shorter treatment courses guided by early viral responses might be also suitable for acute HCV patients coinfected with HIV in whom treatment initiation is significantly delayed. 















Competing interests: None declaredFunding: NoneEthical approval: Not required






















References
 ADDIN EN.REFLIST [1] Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference. AIDS (London, England). 2011;25:399-409.
[2] Thein HH, Yi Q, Dore GJ, Krahn MD. Natural history of hepatitis C virus infection in HIV-infected individuals and the impact of HIV in the era of highly active antiretroviral therapy: a meta-analysis. AIDS (London, England). 2008;22:1979-91.
[3] Fierer DS, Dieterich DT, Fiel MI, Branch AD, Marks KM, et al. Rapid Progression to Decompensated Cirrhosis, Liver Transplant, and Death in HIV-Infected Men After Primary Hepatitis C Virus Infection. Clinical Infectious Diseases. 2013;56:1038-43.
[4] Dominguez S, Ghosn J, Valantin MA, Schruniger A, Simon A, et al. Efficacy of early treatment of acute hepatitis C infection with pegylated interferon and ribavirin in HIV-infected patients. AIDS (London, England). 2006;20:1157-61.
[5] Lambers FA, Brinkman K, Schinkel J, Spijkerman IJ, Molenkamp R, et al. Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration. AIDS (London, England). 2011;25:1333-6.
[6] Vogel M, Nattermann J, Baumgarten A, Klausen G, Bieniek B, et al. Pegylated interferon-alpha for the treatment of sexually transmitted acute hepatitis C in HIV-infected individuals. Antiviral therapy. 2006;11:1097-101.
[7] Torriani FJ, Rodriguez-Torres M, Rockstroh JK, Lissen E, Gonzalez-Garcia J, et al. Peginterferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. The New England journal of medicine. 2004;351:438-50.
[8] Fierer DS DD, Mullen MP, Branch AD, Uriel AJ, Carriero DC, et al. Telaprevir in the treatment of acute HCV infection in HIV-infected men. Clinical Infectious Diseases. 2014; 58(6): 873-9
[9] Vogel M, Dominguez S, Bhagani S, Azwa A, Page E, et al. Treatment of acute HCV infection in HIV-positive patients: experience from a multicentre European cohort. Antiviral therapy. 2010;15:267-79.
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Table 1. Baseline characteristics and virologic responses of the 6 HIV patients with acute HCV infection who completed treatment

Patient 1 Patient 2Patient 3Patient 4Patient 5Patient 6Age394239313230CD4 count, cells/mL787340750562442670Antiretroviral therapyAtriplaABC+EFVAtriplaAtripla Truvada+ATZ/RTruvada+NVPTime between HIV and HCV diagnoses,a years1249412Genotype1a44444Treatment baseline HCV VL,b IU/mL11,827700,0002,254,258950,5562,206,61784,000Time to treatment,c weeks482836601628RVRd IU/mLYesYes1045Yes630Yes cEVRe IU/mLYes Yes Yes Yes Yes 630SVRfYes Yes Yes Yes Yes YesDuration of treatment, weeks242432242848





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bTreatment baseline HCV VL, IU mL-1: VL before starting treatment 
cTime to treatment, weeks: time between the onset of acute HCV infection and initiation of treatment 
dRVR: Rapid virological response
ecEVR: Complete early virological response
fSVR: Sustained virological response


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A.</author><author>Schruniger, A.</author><author>Simon, A.</author><author>Bonnard, P.</author><author>Caumes, E.</author><author>Pialoux, G.</author><author>Benhamou, Y.</author><author>Thibault, V.</author><author>Katlama, C.</author></authors></contributors><auth-address>Department of Infectious and Tropical Diseases/INSERM U 720, CHU Pitie-Salpetriere, 47-83 Boulevard de l&apos;Hopital, 75651 Paris Cedex 13, France. stephanie.dominguez@psl.ap-hop-paris.fr</auth-address><titles><title>Efficacy of early treatment of acute hepatitis C infection with pegylated interferon and ribavirin in HIV-infected patients</title><secondary-title>AIDS</secondary-title><alt-title>AIDS (London, England)</alt-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><alt-periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></alt-periodical><pages>1157-61</pages><volume>20</volume><number>8</number><edition>2006/05/13</edition><keywords><keyword>Acute Disease</keyword><keyword>Adult</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>Antiviral Agents/adverse effects/ therapeutic use</keyword><keyword>CD4 Lymphocyte Count</keyword><keyword>Drug Therapy, Combination</keyword><keyword>HIV Infections/ complications/drug therapy/immunology</keyword><keyword>HIV-1/isolation &amp; purification</keyword><keyword>Hepacivirus/isolation &amp; purification</keyword><keyword>Hepatitis C/complications/ drug therapy/immunology</keyword><keyword>Humans</keyword><keyword>Interferon-alpha/adverse effects/ therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Pilot Projects</keyword><keyword>Polyethylene Glycols/adverse effects/ therapeutic use</keyword><keyword>Prospective Studies</keyword><keyword>RNA, Viral/blood</keyword><keyword>Recombinant Proteins</keyword><keyword>Ribavirin/adverse effects/ therapeutic use</keyword><keyword>Treatment Outcome</keyword><keyword>Viral Load</keyword></keywords><dates><year>2006</year><pub-dates><date>May 12</date></pub-dates></dates><isbn>0269-9370 (Print)&#xD;0269-9370 (Linking)</isbn><accession-num>16691067</accession-num><urls></urls><electronic-resource-num>10.1097/01.aids.0000226956.02719.fd</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Lambers</Author><Year>2011</Year><RecNum>33</RecNum><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">33</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lambers, F. A.</author><author>Brinkman, K.</author><author>Schinkel, J.</author><author>Spijkerman, I. J.</author><author>Molenkamp, R.</author><author>Coutinho, R. A.</author><author>Prins, M.</author><author>van der Meer, J. T.</author></authors></contributors><auth-address>Department of Research, Public Health Service of Amsterdam, Cluster of Infectious Diseases, The Netherlands.</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration</title><secondary-title>AIDS</secondary-title><alt-title>AIDS (London, England)</alt-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><alt-periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></alt-periodical><pages>1333-6</pages><volume>25</volume><number>10</number><edition>2011/04/26</edition><keywords><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Drug Administration Schedule</keyword><keyword>HIV Infections/ complications/drug therapy</keyword><keyword>Hepatitis C/ drug therapy</keyword><keyword>Hepatitis C Antibodies/ drug effects</keyword><keyword>Homosexuality, Male</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Viral Load/ drug effects</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun 19</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21516025</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e3283480144</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Vogel</Author><Year>2006</Year><RecNum>30</RecNum><record><rec-number>30</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">30</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vogel, M.</author><author>Nattermann, J.</author><author>Baumgarten, A.</author><author>Klausen, G.</author><author>Bieniek, B.</author><author>Schewe, K.</author><author>Jessen, H.</author><author>Boesecke, C.</author><author>Rausch, M.</author><author>Lutz, T.</author><author>Fenske, S.</author><author>Schranzo, D.</author><author>Kummerle, T.</author><author>Schuler, C.</author><author>Theisen, A.</author><author>Mayr, C.</author><author>Seidel, T.</author><author>Rockstroh, J. K.</author></authors></contributors><auth-address>Department of Medicine I, University of Bonn, Germany.</auth-address><titles><title>Pegylated interferon-alpha for the treatment of sexually transmitted acute hepatitis C in HIV-infected individuals</title><secondary-title>Antivir Ther</secondary-title><alt-title>Antiviral Therapy</alt-title></titles><periodical><full-title>Antivir Ther</full-title><abbr-1>Antiviral therapy</abbr-1></periodical><alt-periodical><full-title>Antivir Ther</full-title><abbr-1>Antiviral therapy</abbr-1></alt-periodical><pages>1097-101</pages><volume>11</volume><number>8</number><edition>2007/02/17</edition><keywords><keyword>Adult</keyword><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>HIV Infections/ complications</keyword><keyword>Hepatitis C/ drug therapy/etiology/transmission</keyword><keyword>Humans</keyword><keyword>Interferon-alpha/ therapeutic use</keyword><keyword>Male</keyword><keyword>Polyethylene Glycols/ therapeutic use</keyword><keyword>Recombinant Proteins</keyword><keyword>Sexually Transmitted Diseases, Viral/drug therapy/etiology/transmission</keyword></keywords><dates><year>2006</year></dates><isbn>1359-6535 (Print)&#xD;1359-6535 (Linking)</isbn><accession-num>17302380</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Torriani</Author><Year>2004</Year><RecNum>35</RecNum><record><rec-number>35</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">35</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Torriani, F. 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T.</author></authors></contributors><auth-address>Department of Medicine, Division of Infectious Diseases, University of California, San Diego, AntiViral Research Center, CA 92103, USA. ftorriani@ucsd.edu</auth-address><titles><title>Peginterferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients</title><secondary-title>N Engl J Med</secondary-title><alt-title>The New England journal of medicine</alt-title></titles><periodical><full-title>N Engl J Med</full-title><abbr-1>The New England journal of medicine</abbr-1></periodical><alt-periodical><full-title>N Engl J Med</full-title><abbr-1>The New England journal of medicine</abbr-1></alt-periodical><pages>438-50</pages><volume>351</volume><number>5</number><edition>2004/07/30</edition><keywords><keyword>Adult</keyword><keyword>Antiviral Agents/adverse effects/ therapeutic use</keyword><keyword>Drug Therapy, Combination</keyword><keyword>Female</keyword><keyword>Genotype</keyword><keyword>HIV Infections/ complications</keyword><keyword>Hepacivirus/drug effects/genetics</keyword><keyword>Hepatitis C Antibodies/blood</keyword><keyword>Hepatitis C, Chronic/complications/ drug therapy</keyword><keyword>Humans</keyword><keyword>Interferon-alpha/adverse effects/ therapeutic use</keyword><keyword>Male</keyword><keyword>Polyethylene Glycols</keyword><keyword>RNA, Viral/blood</keyword><keyword>Recombinant Proteins</keyword><keyword>Ribavirin/adverse effects/ therapeutic use</keyword></keywords><dates><year>2004</year><pub-dates><date>Jul 29</date></pub-dates></dates><isbn>1533-4406 (Electronic)&#xD;0028-4793 (Linking)</isbn><accession-num>15282351</accession-num><urls></urls><electronic-resource-num>10.1056/NEJMoa040842</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Fierer DS</Author><Year>2013 in press</Year><RecNum>37</RecNum><record><rec-number>37</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">37</key><key app="ENWeb" db-id="">0</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fierer DS, Dieterich DT, Mullen MP, Branch AD, Uriel AJ, Carriero DC, van Seggelen WO, Hijdra RM, Cassagnol DG.  </author></authors></contributors><titles><title>Telaprevir in the treatment of acute HCV infection in HIV-infected men</title><secondary-title>Clinical Infectious Diseases</secondary-title></titles><periodical><full-title>Clinical Infectious Diseases</full-title></periodical><dates><year>2013 in press</year><pub-dates><date>in press</date></pub-dates></dates><urls></urls></record></Cite></EndNote>sD���y������K�	_ENREF_1sD���y������K�	_ENREF_4�D<EndNote><Cite><Author>Vogel</Author><Year>2010</Year><RecNum>9</RecNum><DisplayText>[1, 5, 9]</DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">9</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vogel, M.</author><author>Dominguez, S.</author><author>Bhagani, S.</author><author>Azwa, A.</author><author>Page, E.</author><author>Guiguet, M.</author><author>Valantin, M. A.</author><author>Katlama, C.</author><author>Rockstroh, J. K.</author><author>Nelson, M.</author></authors></contributors><auth-address>Department of Internal Medicine I, Bonn University, Bonn, Germany. martin.vogel@ukb.uni-bonn.de</auth-address><titles><title>Treatment of acute HCV infection in HIV-positive patients: experience from a multicentre European cohort</title><secondary-title>Antivir Ther</secondary-title></titles><periodical><full-title>Antivir Ther</full-title><abbr-1>Antiviral therapy</abbr-1></periodical><pages>267-79</pages><volume>15</volume><number>2</number><edition>2010/04/14</edition><keywords><keyword>Adult</keyword><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Cohort Studies</keyword><keyword>Drug Therapy, Combination</keyword><keyword>Europe</keyword><keyword>HIV Infections/ complications</keyword><keyword>Hepacivirus/classification/ drug effects/genetics</keyword><keyword>Hepatitis C/complications/ drug therapy/virology</keyword><keyword>Humans</keyword><keyword>Interferon-alpha/ therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Polyethylene Glycols/ therapeutic use</keyword><keyword>RNA, Viral/blood</keyword><keyword>Recombinant Proteins</keyword><keyword>Ribavirin/ therapeutic use</keyword><keyword>Treatment Outcome</keyword></keywords><dates><year>2010</year></dates><isbn>2040-2058 (Electronic)&#xD;1359-6535 (Linking)</isbn><accession-num>20386082</accession-num><urls></urls><electronic-resource-num>10.3851/imp1501</electronic-resource-num><remote-database-provider>nlm</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Lambers</Author><Year>2011</Year><RecNum>33</RecNum><record><rec-number>33</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">33</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lambers, F. 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T.</author></authors></contributors><auth-address>Department of Research, Public Health Service of Amsterdam, Cluster of Infectious Diseases, The Netherlands.</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration</title><secondary-title>AIDS</secondary-title><alt-title>AIDS (London, England)</alt-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><alt-periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></alt-periodical><pages>1333-6</pages><volume>25</volume><number>10</number><edition>2011/04/26</edition><keywords><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Drug Administration Schedule</keyword><keyword>HIV Infections/ complications/drug therapy</keyword><keyword>Hepatitis C/ drug therapy</keyword><keyword>Hepatitis C Antibodies/ drug effects</keyword><keyword>Homosexuality, Male</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Viral Load/ drug effects</keyword></keywords><dates><year>2011</year><pub-dates><date>Jun 19</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21516025</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e3283480144</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>(NEAT)</Author><Year>2011</Year><RecNum>8</RecNum><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>European AIDS Treatment Network (NEAT) </author></authors></contributors><titles><title>Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference</title><secondary-title>AIDS</secondary-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><pages>399-409</pages><volume>25</volume><number>4</number><edition>2010/12/09</edition><keywords><keyword>AIDS-Related Opportunistic Infections/classification/ diagnosis/epidemiology</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>HIV Infections/complications/epidemiology</keyword><keyword>Hepatitis C/complications/ diagnosis/epidemiology/ therapy</keyword><keyword>Humans</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb 20</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21139491</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e328343443b</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>sD���y������K�	_ENREF_1sD���y������K�	_ENREF_5sD���y������K�	_ENREF_9�D<EndNote><Cite><Author>(NEAT)</Author><Year>2011</Year><RecNum>8</RecNum><DisplayText>[1, 10]</DisplayText><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>European AIDS Treatment Network (NEAT) </author></authors></contributors><titles><title>Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference</title><secondary-title>AIDS</secondary-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><pages>399-409</pages><volume>25</volume><number>4</number><edition>2010/12/09</edition><keywords><keyword>AIDS-Related Opportunistic Infections/classification/ diagnosis/epidemiology</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>HIV Infections/complications/epidemiology</keyword><keyword>Hepatitis C/complications/ diagnosis/epidemiology/ therapy</keyword><keyword>Humans</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb 20</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21139491</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e328343443b</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Arends</Author><Year>2011</Year><RecNum>6</RecNum><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">6</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arends, J. E.</author><author>Lambers, F. A.</author><author>van der Meer, J. T.</author><author>Schreij, G.</author><author>Richter, C.</author><author>Brinkman, K.</author><author>Hoepelman, A. I.</author><author>The Netherlands Society for, Aids Physicians-Nvab</author></authors></contributors><auth-address>Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands. J.E.Arends@umcutrecht.nl</auth-address><titles><title>Treatment of acute hepatitis C virus infection in HIV+ patients: Dutch recommendations for management</title><secondary-title>Neth J Med</secondary-title></titles><pages>43-9</pages><volume>69</volume><number>1</number><edition>2011/02/18</edition><keywords><keyword>Acute Disease</keyword><keyword>Anti-HIV Agents/ therapeutic use</keyword><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Evidence-Based Medicine</keyword><keyword>HIV Infections/ drug therapy/epidemiology</keyword><keyword>Hepatitis C/ drug therapy/epidemiology</keyword><keyword>Humans</keyword><keyword>Netherlands</keyword><keyword>Practice Guidelines as Topic</keyword><keyword>Societies, Medical</keyword><keyword>Time Factors</keyword></keywords><dates><year>2011</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1872-9061 (Electronic)&#xD;0300-2977 (Linking)</isbn><accession-num>21325703</accession-num><urls></urls><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite></EndNote>sD���y������K�	_ENREF_1uD���y������K�
_ENREF_10XD<EndNote><Cite><Author>Vogel</Author><Year>2010</Year><RecNum>9</RecNum><DisplayText>[1, 9-11]</DisplayText><record><rec-number>9</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">9</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vogel, M.</author><author>Dominguez, S.</author><author>Bhagani, S.</author><author>Azwa, A.</author><author>Page, E.</author><author>Guiguet, M.</author><author>Valantin, M. A.</author><author>Katlama, C.</author><author>Rockstroh, J. K.</author><author>Nelson, M.</author></authors></contributors><auth-address>Department of Internal Medicine I, Bonn University, Bonn, Germany. martin.vogel@ukb.uni-bonn.de</auth-address><titles><title>Treatment of acute HCV infection in HIV-positive patients: experience from a multicentre European cohort</title><secondary-title>Antivir Ther</secondary-title></titles><periodical><full-title>Antivir Ther</full-title><abbr-1>Antiviral therapy</abbr-1></periodical><pages>267-79</pages><volume>15</volume><number>2</number><edition>2010/04/14</edition><keywords><keyword>Adult</keyword><keyword>Antiviral Agents/ therapeutic use</keyword><keyword>Cohort Studies</keyword><keyword>Drug Therapy, Combination</keyword><keyword>Europe</keyword><keyword>HIV Infections/ complications</keyword><keyword>Hepacivirus/classification/ drug effects/genetics</keyword><keyword>Hepatitis C/complications/ drug therapy/virology</keyword><keyword>Humans</keyword><keyword>Interferon-alpha/ therapeutic use</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Polyethylene Glycols/ therapeutic use</keyword><keyword>RNA, Viral/blood</keyword><keyword>Recombinant Proteins</keyword><keyword>Ribavirin/ therapeutic use</keyword><keyword>Treatment Outcome</keyword></keywords><dates><year>2010</year></dates><isbn>2040-2058 (Electronic)&#xD;1359-6535 (Linking)</isbn><accession-num>20386082</accession-num><urls></urls><electronic-resource-num>10.3851/imp1501</electronic-resource-num><remote-database-provider>nlm</remote-database-provider><language>eng</language></record></Cite><Cite><Author>(NEAT)</Author><Year>2011</Year><RecNum>8</RecNum><record><rec-number>8</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">8</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>European AIDS Treatment Network (NEAT) </author></authors></contributors><titles><title>Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference</title><secondary-title>AIDS</secondary-title></titles><periodical><full-title>AIDS</full-title><abbr-1>AIDS (London, England)</abbr-1></periodical><pages>399-409</pages><volume>25</volume><number>4</number><edition>2010/12/09</edition><keywords><keyword>AIDS-Related Opportunistic Infections/classification/ diagnosis/epidemiology</keyword><keyword>Antiretroviral Therapy, Highly Active</keyword><keyword>HIV Infections/complications/epidemiology</keyword><keyword>Hepatitis C/complications/ diagnosis/epidemiology/ therapy</keyword><keyword>Humans</keyword></keywords><dates><year>2011</year><pub-dates><date>Feb 20</date></pub-dates></dates><isbn>1473-5571 (Electronic)&#xD;0269-9370 (Linking)</isbn><accession-num>21139491</accession-num><urls></urls><electronic-resource-num>10.1097/QAD.0b013e328343443b</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Boesecke</Author><Year>2012</Year><RecNum>7</RecNum><record><rec-number>7</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">7</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Boesecke, C.</author><author>Rockstroh, J. K.</author></authors></contributors><auth-address>Department of Internal Medicine I, University of Bonn, Bonn, Germany.</auth-address><titles><title>Acute hepatitis C in patients with HIV</title><secondary-title>Semin Liver Dis</secondary-title></titles><pages>130-7</pages><volume>32</volume><number>2</number><edition>2012/07/05</edition><keywords><keyword>Antiviral Agents/ administration &amp; dosage</keyword><keyword>Australia/epidemiology</keyword><keyword>Coinfection/diagnosis/ drug therapy/epidemiology</keyword><keyword>Europe/epidemiology</keyword><keyword>Female</keyword><keyword>HIV Infections/ complications/epidemiology</keyword><keyword>Hepatitis C/diagnosis/ drug therapy/epidemiology</keyword><keyword>Humans</keyword><keyword>Interferons/ administration &amp; dosage</keyword><keyword>Male</keyword><keyword>Ribavirin/ administration &amp; dosage</keyword><keyword>United States/epidemiology</keyword></keywords><dates><year>2012</year><pub-dates><date>May</date></pub-dates></dates><isbn>1098-8971 (Electronic)&#xD;0272-8087 (Linking)</isbn><accession-num>22760652</accession-num><urls></urls><electronic-resource-num>10.1055/s-0032-1316468</electronic-resource-num><remote-database-provider>NLM</remote-database-provider><language>eng</language></record></Cite><Cite><Author>Arends</Author><Year>2011</Year><RecNum>6</RecNum><record><rec-number>6</rec-number><foreign-keys><key app="EN" db-id="we9ads9t6f92aqepezbvfep62s9vvxed9s09">6</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arends, J. E.</author><author>Lambers, F. A.</author><author>van der Meer, J. T.</author><author>Schreij, G.</author><author>Richter, C.</author><author>Brinkman, K.</author><author>Hoepelman, A. I.</author><author>The Netherlands Society for, Aids Physicians-Nvab</author></authors></contributors><auth-address>Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands. 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A.</author><author>Katlama, C.</author><author>Rockstroh, J. 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