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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
          
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hiv/hcv co-infection, do I start hiv/hcv treatment?
Dec 28, 2001

Hi, My brother just gave me the news he is hiv+ and has hep c. he's had hiv for 8 years and has t-cell count of 380-390. He is not taking meds for anything. He was an ivdu in NY(if that helps) shouldn't he be looking into starting some medication therapy?

Response from Dr. Rodriguez-Torres

Yes,he should discuss this with his physician.The most important thing will be to check the status of his liver as chronic Hep,C is more agressive,and progresses more rapidly in HIV,and patients should be treated earlier and more agressively than the monoinfected patients.He may start the HCV therapy before the HIV,but usually we give both therapies at the same time.This will depend on his HIV viral load,and overall state of health,as now HIV treaters are again waiting for therapy till the HIV is decreasing significantly the CD4.Less than 400,may be a level where he may need both therapies,.What I usually prefer is to have the patients in a stable therapy for HIV ,and then to start HCV drugs,In that way I will not have many problems with HIV drugs changes during HCV therapy.Tell your brother to go to the doctor for treatment evaluation.



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