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A question on HCV clearance
Apr 16, 2010

Hi, I am a campaigner/researcher on haemophilia/contaminated blood and the widow of a UK haemophiliac coinfected HIV/HCV.I am increasingly concerned about the number of haemophiliacs dying from liver complications, cirrhosis, cancer of the liver that were told they had "cleared" the hepatitis virus with tests showing "undectable". Do you know of any research articles on this issue? My concern is that once someone is labelled a "clearer" they are no longer monitored for liver changes/problems and are only being picked up in the last weeks of life when its too late. I believe there are too many for it to be co-incidence and often there were no other contributing factors such as alcohol or drug abuse... Many Thanks, Carol Grayson http://www.esrc.ac.uk/ESRCInfoCentre/about/CI/CP/societynow/issue4/blood_trade.aspx

Response from Dr. McGovern

I am so sorry to hear of your loss.

I have had a few patients who responded to treatment for hepatitis C but still developed liver disease secondary to fatty liver disease. This is a real issue in HIV infected patients who are at risk for fatty liver from central obesity....

One of the factors causing this could be the high prevalence of insulin resistance among HIV infected patients.

Fortunately, we are getting away from some of the HIV drugs which are associated with fatty liver - like DDI and stavudine.

You can read more about this in several articles on this subject that have been published; look up hepatic steatosis in PubMed. (We also published research in this area which gives an overview of the main issues in McGovern, Clinical Infectious Diseases August 1st issue 2006)



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