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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Hep C Treatment on Early Diagnosis
Sep 29, 2004

I recently tested positive (July) for Hep C but in Febuary I tested negative so I know roughly how long I've been infected. My Hep C specialist thinks this is great news and that treatment for me may be much more responsive than someone who doesnt know how long they've had the virus. Is this true and can you explain why this would be? I am currently not on any HIV meds as my viral load and other numbers had been very good but now my doctor isn't sure whether or not it would be best to treat the HIV or the Hep C first.

Response from Dr. McGovern

What your doctor is referring to is that treatment of early hepatitis C is much more effective than when you treat it later.

First I would make sure you do need treatment. Some patients clear on their own although this is less likely if you have HIV. It is reasonable to obtain an HCV RNA to see what the level is. Then in a few weeks check it again to see the level is clearing on its own. This approach was described in a paper by Gerlach in Gastroenterology about a year ago.

If your HIV counts are ok, you don't necessarily need to go on treatment.If you do start interferon therapy, your T cells will drop but it is more important to pay attention to your T cell percentages which are more accurate in the setting of Interferon treatment. The percentages stay the same or even increase. Dr. McGovern

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