skip to main content

HCV Treatment Timing with ART — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHepatitisHCV Treatment Timing with ARTSCE Infectious Diseases

A 35-year-old woman with HIV (CD4 150, starting ART) also has chronic hepatitis C (genotype 1a, F2 fibrosis). She asks about the timing of HCV treatment relative to ART initiation. What is the recommendation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Start ART first and stabilise HIV treatment; HCV treatment can follow once ART is established and drug interactions are assessed — HCV treatment is not urgent in compensated F2 disease

In HIV/HCV co-infection, ART initiation takes priority (particularly at CD4 150). HCV treatment is elective in compensated liver disease (F2 fibrosis without cirrhosis) and can be planned after ART is established and tolerated (typically 3–6 months). This allows: (1) assessment of ART-DAA drug interactions (important for PI-based ART), (2) immune reconstitution reducing OI risk during DAA therapy, and (3) avoiding polypharmacy and adherence challenges. For patients with advanced cirrhosis (F4) or rapidly progressive liver disease, earlier HCV treatment may be justified.

Reference: BHIVA 2024 – HCV/HIV; EASL 2024 – HCV; NICE TA499