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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Diagnosis Confirmed HCV
Jan 30, 2005

Hello. Yesterday, my doctor confirmed that I do indeed have an active case of HCV. In addition, I am also HIV+ which is very well mangaged and my immune system is normal. I am wondering, and I realize I am asking you to look into your crystal ball, but what are my chances of being cured or not being cured? If I don't respond to treatment, what is my life expectancy? Thanks.

Response from Dr. McGovern

For patients with HIV and HCV, there was some encouraging data that was published just about six months ago which showed that treatment with pegylated interferon alfa 2a and ribavirin led to an overall response rate of 40 percent. That response rate went up considerably for patients with genotype 2 or 3 infection.

I would consider a liver biopsy if you are hesitant about treatment to see how much "damage" there is. About 15 percent of our patients have minimal disease and do not necessarily pursue treatment. You can then consider therapy based on the biopsy results.

If you do pursue treatment, you can see what your response is after 12 weeks of therapy. If you have not achieved a 2 log drop in virus level or a non-detectable viral load by 12 weeks, then your chance of becoming a sustained responder is low.

I would keep alcohol use to a minimum in the meantime. Dr. McGovern

is 2 months too long to wait for treatment
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