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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Newly diagnosed with hep c,also have hiv..........
Oct 9, 2004

I recently found out I have hep c and may have been co-infected all along. I have been hiv for about 16 years. My HCV viral load is 7 million. My doctor says the hep c hasn't been a problem for me and doesn't recommend treatment at this time. My question is have I cut my chances of survival in half? How realistic is it to believe I can live a long life with both viruses?

Response from Dr. McGovern

I agree that it is certainly possible that your hepatitis C may have been present for a long time.

You have a high viral load. Besides that I do not know anything about the status of your liver disease without knowing the results of a liver biopsy. A biopsy is very important in determining how much scarring and inflammation is present. Simple liver tests - such as ALT and AST - do not tell you anything about the status of the liver.

A liver biopsy would be extremely important since it would help to guide decisions about treatment. This is a very important decision since recently published studies of the use of pegylated interferon and ribavirin have shown important results. Some patients achieve eradication of hepatitis C. Repeat liver biopsies in those who did not achieve eradication of virus demonstrated improvement in their liver disease.

I would discuss the possibility of obtaining a liver biopsy with your physician or with an expert in the liver who has experience with treating patients with HIV. If your liver biopsy shows little disease it will be reassuring and will also serve as a good baseline for comparison in the future to see how fast your scarring is progressing.

As for the effects of HCV on HIV, studies are conflicting and there is no consensus on what the effect is. However, most studies do suggest that HIV can make HCV more progressive in its effect on the liver.

Dr. McGovern

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RE: difference between IU/ML & EQ/ML

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