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HIV/HCV coinfection
Nov 11, 2002

Dear Prof. Dr. Dieterich,

My name is Alexander; I'm male, 31 year old, with Bachelor Science in Telecommunications. I have diagnosed HCV infection 4.12.2001. (using anti HCV ELISA test). After that my doctor made Liver biopsy (16.1.2002.) to confirm HCV and to see the level of liver inflammation. (The pathologist resume report was low-level activities, without fibrosis).

I also made PCR HCV RNK (Amplicor Roche), witch result positive, with titer > 10 000 K/ml. (It looks very high, isn't it?) I performed this PCR on 15.2.2002.

Lab results (24.9.2002.): S-bilirubin overall: 26 S-Bilirubin direct: 12 S-AST (GOT): 21 S-ALT (GPT): 20 S-gama-GT: 29

WBC 6.0x10^9 LY 2.1 .349 MO 0.3 .044 GR 3.6 .607

Plt 141 x 10^9 MPV 10 fL Pct .141 PDW 16.0

My doctor now recommends me Interferon alpha therapy. I said that I would postpone it to the January of 2003 because I can't take sick leave now.

I also had one risk contact (with protection) on 13.09.2002. and I'm worried about HIV. I made anti HIV test 26.10.2002. NEGATIVE. I know that I have to wait six mounts to be sure that I'm negative. I have sneeze, laxity and also dizziness, no fever.

The question is: What should I do if I find myself HIV+? Shall I take Interferon therapy or wait (half of year) for HIV therapy? How to treat HIV and HCV co infection?

Thank you very much in advance for answers.

Response from Dr. Dieterich

It does not sound like you have HIV. However if you do, then it depends on the numbers of CD4 cells and HIV whether you should be treated. If you were recently infected then you should take the HIV meds first for a few months and then start the HCV treatment. Either way you should begin you HCV treatment soon. Ask your MD to check your HIV PCR and if it is negative then go ahead with the interferon. DTD



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