HCV Geno 2b + HIV: What About Us
Nov 17, 2012
Although I supposedly had the "easier" HCV genotype to treat, my therapy a few years ago (RBV + PegINF), and I attained SVR .... I relapsed. Retesting confirmed I had Geno 2b only. My VL for HIV has always been undetectable and I'm hypercompliant. My CD4s, once down to 96 at Dx (when I had AIDS related CNS NHL) got up to 350 or so ..... then plateaued and steadily decreased to around 260 and has been steady. I'm now 55, and contracted HCV (most probably) from one of 2 field transfusions in Pakistan; and HIV from a week of transfusions (25+ units)... So here's my ?, given all the background: Why can't I get the one of the new retroviral HCV therapies. My HIV dr. & Heptologist says I can't ... because I'm geno 2. Has the FDA cleared bocepevir, etc., for Geno 2, coinfected HIV who relapsed from SVR after conventional Tx.? i can't get a straight answer from anybody. Thank you!
Response from Dr. Taylor
I am sorry to hear that you relapsed after competing treatment for hepatitis C genotype 2 infection. This can be so disappointing. It is wonderful that your HIV VL is undetectable as this is important for both your HIV and hepatitis C infections.
There is a good reason why you cannot get one of the new hepatitis C pills, the protease inhibitors telaprevir and boceprevir. These medications are not active against genotype 2 infection. No one with genotype 2 infection should take these medications.
The good news is that there are many medications under study that are active against genotype 2 infection. There are some classes of hepatitis C medications under investigation that are active against all genotypes, while other medications being studied may be particularly suited for your genotype.
There are clinical trials open now for people living with both HIV and hepatitis C genotype 2 infection. Depending on where you live your doctor may be able to help you gain access to these trials. If you cannot access a study, it is looking as though within a few years there will be a number of better options for genotype 2 infection for people with and without co-existing HIV infection.
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