Are there any data that suggest longer treatment has a greater likelihood of cure. Specifically, a friend's liver specialist has suggested he stay on his interferon and ribatron therapy longer than the recommended 6 months, since he is co-infected with HIV. He has genotype "2" virus. His HEP C viral load has been undetectable for the past few months (as is his HIV viral load), and liver enzymes are within normal range. Is there any reason to extend the therapy. He is having unpleasant side effects, i.e., severe lethargy, body aches, depression, and irritability, and would prefer not to stay on treatment longer than necessary. However, if there were data suggesting prognosis would be improved he would consider longer treatment. Your advice is greatly appreciated.

Generally speaking, longer is better. Most of us treat HIV+ patients with genotype 2 and 3 for 12 months, because we assume that there is a higher relapse rate. Psychologically I feel it is better to go longer and be reasonably certain of a cure than stop and have to go back on therapy for the second time certainly for a year. DTD