Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
  Breaking News: FDA Approves Triumeq, New Once-Daily Combination Pill
   
Ask the Experts About

Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
           
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  
  • Email Email
  • Glossary Glossary


co-infection
Sep 3, 2006

if hep c can be cured,then why is it so hard to treat someone coinfected?wouldnt it be wise to treat hep c first,then hiv?and can someone carry hep c and hiv for more than 12 years and not know?(alivehoping)on the boards

Response from Dr. McGovern

You ask the million dollar question. I will answer with the following:

1. HIV/HCV coinfected patients can be cured. Up to 40% in the APRICOT trial who went on pegylated interferon alfa 2a plus ribavirin developed a sustaind virologic response.

2. Sustained virologic response usually translates into long term "cure", even in patients with HIV.

3. Genotypes 2 and 3 are much easier to treat than genotypes 1 and That is particularly true of coinfection as well.

4. Our biggest problem is with high viral load genotype 1 infection. Several studies suggest that coinfected patients have higher HCV viral loads than patients without HIV. I believe that this is our biggest obstacle.

5. The emphasis in recent HCV trials has been on whether a patient is achieving a rapid viral load on treatment - measured in some studies as early as 4 weeks. The other important time point is the 12 week viral load. This result basically infers whether a patient has little chance of responding at all. These two results tell us very different things. If a patient has HIV and has a very high viral load, this affects both the 4 and 12 weeks results and has an impact on outcome. Should we treat longer? With higher doses of PEG?

6. The other issue is related to ribavirin. Most of the clinical trials have used 800 mg a day in coinfected patients due to concerns about toxicity. The drug appears to be relatively safe so now a study called PRESCO is evaluating whether increasing the dose of ribavirin can help increase response rates in patients with high viral load genotype 1 infection.

7. As for your last comment - order of treatment HIV or HCV... That will certainly depend on the relative stages of each infection. There are no hard and fast rules and I believe each patient is unique and an individual case.



Previous
partner hbv myself hiv
Next
Seroconvert?

  
  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS


 
Advertisement



Q&A TERMS OF USE

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint

Advertisement