Dec 30, 2009
how long do people live when they have both hiv and hep c
| Response from Dr. McGovern
My feeling is that the most important issue is to stay healthy with the medications that are available and to do your best to prevent complications. So...
If an HIV/HCV coinfected patient has liver disease and is not on HIV medications, there should be consideration of treatment for HCV infection. If the therapy does not work, then I discuss starting HIV medications, regardless of CD4 count, since there is some information that suppression of HIV is also beneficial for liver health. I also review HCV treatment records of a patient who is referred to me to see if there is anything that could be optimized better for their HCV therapy that might lead me to think that re-treatment could be beneficial.
If an HIV/HCV coinfected patient is immunosuppressed, it may be better to first start HIV medications to suppress HIV and to attain better CD4 T cell numbers. Then a trial of HCV therapy can be considered.
The good news is that newer medications are in development for HCV that will hopefully benefit HIV/HCV coinfected patients as well - particularly those who have high viral loads with genotype 1 HCV infection.
It is important to avoid alcohol when a person has HCV...Also important to be immunized against hepatitis A and B.
Liver disease is extremely important in HIV/HCV coinfected patients, but I feel that we are making progress in understanding how important HIV suppression may be to liver health.
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