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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Hepatitis C
Dec 12, 2009

Six years ago I tested positive for HIV and Hepatitis C. My viral load is undetectable and my cd4 is 564. I have never been ill nor have I had any complication due to the meds. However, I was told that the Hep.C is at a code (F2)and the viral load is very high for Hep C. I was told that I am at risk for liver cancer and liver failure. I was told that a liver biopsy would have to be done. Do you know what a (F2) is? Do you know if their are any treatments available for Hep C. I am a healthy HIV POSitive 49 year african american male who has NEVER been sick and now i am starting to worry. I workout 4 to 5 days a week;I dont drink but i do smoke pot daily.

Response from Dr. McGovern

I am a bit confused because you say that you have F2 disease which is usually a diagnosis made after a biopsy...and yet you say that you have been advised to have a biopsy....Perhaps your diagnosis of F2 (moderate fibrosis) was made after a non-invasive marker was sent?

These markers are helpful in the extremes (mild disease or advanced disease); in between they are not as reliable, so perhaps that is why your doctor wants to get a biopsy to get more information. I certainly would agree with that approach.

The fact that your HIV is non-detectable and your CD4 is so high is good news for your liver since this has been shown to be protective and associated with slower rates of fibrosis progression.

Another good piece of news is that there are going to be results of trials examining the efficacy of HCV protease inhibitors in combination with interferon and ribavirin for the treatment of HIV infected patients. These drugs are potent and are associated with good response rates in patients with HCV alone. Since you have a high viral load, it may be reasonable to see if you can get into a clinical trial or await the results of these trials...

However, whether you can wait or not will strongly depend on how much disease you have at present. You will need to discuss that with your doctor.

Finally, you are not at risk for liver failure or hepatocellular carcinoma until you develop cirrhosis - which you do not have....

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