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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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HIV/HVC treatment Duration
Jul 22, 2006

I am currently under the care of two fine physicians at the University Of Michigan in Ann Arbor; however I am looking for more information on treatment protocols for co-infection.

My HIV VL is undetectable, with excellent CD4 and T-Cell values (Viread, Videx, and Sustiva). In March, I began treatment for HVC genotype 2, stage 1 (biopsy results) with Pegasys 180 and Ribavirin 200MG (3x twice daily). I achieved an undetectable VL at the standard 12 week interval.

I am 100% Med Compliant.

My question for you is the duration protocols. Has it been determined that 24 weeks is sufficient to achieve SVR with genotype 2, or even with EVR must all patients regardless of genotype complete 48 weeks?

Response from Dr. McGovern

You ask an excellent question.

As you are alluding to, treatment of genotype 2 in patients with hepatitis C alone is for 24 weeks. In patients who have a rapid viral load response (no detectable virus after 4 weeks) the treatment duration is even shorter.

However, we do not know the answer to your question in HIV infected patients -just yet. There is a study named PRESCO which is being performed in Spain that is examining whether rapid viral load responders (at 4 weeks) may respond to a shorter course of therapy for favorable genotypes. I expect the results to come out this fall.

The key here is that the 4 week viral load response is a newly described "positive predictor" of a sustained response; the 12 week viral load is a "negative predictor"; it tells you who is unlikely to respond at all.

I hope this is helpful.

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