Approximately 25% of people infected with human immunodeficiency virus (HIV) are co-infected with hepatitis C virus (HCV) 1. Many studies have shown that HIV infection worsens the prognosis of HCV infection, with an increase twice as fast fibrosis and therefore the risk of cirrhosis and in patients with cirrhosis, a risk of progression to decompensated cirrhosis, about 5 times 2, 3. In the 10-15 years after infection with HCV, 25% of HIV patients co-infected will develop cirrhosis cons 2-6% of patients not infected with HIV, the absence of specific treatment..

Thus, while the availability of highly active antiretroviral therapy has led to a dramatic decrease of HIV-related mortality, mortality due to chronic hepatitis C continues to be increasing, with 11% of deaths in 2005, making it the second to third leading cause of death unrelated to HIV in these patients 4. This underlines the need for a C viral eradication in patients co-infected, as it allows histological improvement is reflected in the medium term by a substantial reduction morbidity and mortality from liver 5.

Significant therapeutic advances have been made since 20 years and in 2009 the current treatment combining pegylated interferon and ribavirin achieves viral eradication ( SVR or SVR) in 55-60% of patients mono-infected with HCV 6. In patients co-infected with HIV, the results are below, the first clinical trials reporting a SVR rates ranging between 27% and 44% with a higher rate for Ge genotypes 2 and 3 (range 44-73%) and lower for genotypes 1 and 4 (14-38%) 7. For concerns about patient tolerance and treatment compliance are added to those of doctors about the chances of treatment success found some modest, all leading to a rate of C antiviral therapy abnormally low in this population 8. These elements were quickly stressed the importance of better understanding the determinants of response to anti-HCV, factors predictive of the efficacy and toxicity of anti-HCV, potential interactions with antiretroviral therapy and the need for optimization of this treatment in patients co-infected by HIV.