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HCV Geno 2b Relapser HIV Coinfected Shut Out?
Jan 14, 2012

Good Morning Good Dr. M.,

I had a sky high VL for HCV, geno 2b ...... did a 48 wk "stint" of peg interferon/Ribovirin .... became undetectable for HCV some time around the 8th wk of Tx .... but alas, I relapsed as shown by testing 6 mos. post-Tx. That Tx was finished in 2009 ..... So, when the new HC drugs came out I asked the Hepatologist about the new HCV retrovirals .....

I was floored when he told me that the new HCV drugs were "only approved for Geno 1 HCV" ....AND since I was co-infected I "was out because of that too" .....

My HIV has be undetectable since starting retros (Atripla &Isentress).... So what gives? Geno 2s and 3s will never be approved since there are so few of us for clinical trials ..... and the hepatologist said he was "scared out of his wits" because the new HCV retrovirals "might" mutate the HIV somehow.

I want to be free of HCV if I can .... everybody says that would be good to reduce overall body inflamation in addition to the possible cirrohsis down the line. Is the mutation "threat" really a concern? Are there any trials for Geno 2 Co-infecteds? Inquiring minds want to know. Thanx Doctor!!

Response from Dr. McGovern

While it is true that boceprevir and telaprevir have only been approved for genotype 1 infection, there are several drugs in development that are active against other genotypes.

For example, there is a protease inhibitor that is in development called MK-5172, which is active against all HCV genotypes. A short study was done over 7 days of drug dosing to see the safety profile. The drug appears safe over this short time frame and dropped virus down by more than 4 logs (that's a great amount) over 7 days in both genotype 1 and 3 patients.

In addition, a small study of PSI-7977, a nucleotide inhibitor, plus ribavirin led to cure in 10 out of 10 patients with Genotype 2 and 3 infection. When these data were shown at the liver research meeting in San Francisco, it was incredibly exciting.

So medications are on their way. Hang in there. You will be cured of your HCV. It is just a matter of time. In the meantime, don't drink alcohol to excess and keep your weight trim.



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