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HIV and Hep C Co infection
Dec 15, 2012

I was recently diagnosed last year with full blown Aids and Hep C... I responded well to Atripla very quickly although I had horrible nightmares, Atripla stopped working in July 2012 and was put on Truvada and Isentress... My physician wants me to participate in a research study with Ribavarin, Peg interferon and Boceprevir(pro tease inhibitor) I am not sure I want to participate as I am afraid of the complicationsThanks so much! Ron

Response from Dr. Taylor

I am glad that you started on HIV medications, this is very important. It is wonderful that you are thinking about your hepatitis C infection. In my view ALL people with both HIV and hepatitis C should be cured of hepatitis C; the question is, WHEN is the right time for each individual? Things to consider are which medications are available, the chance of cure with these medications, potential side effects, drug interactions with other medications, how one's HIV is doing, other health issues, how things are going in one's life and whether you can take on the 'part time job' of hepatitis C treatment and adhering to the medications fully, and the amount of damage in one's liver.

First, it is important to cut down or stop smoking and using alcohol, as both can harm the liver infected with hepatitis C. Talk with your doctor if you need assistance with this. Talk with your doctor about how not to spread HCV to your partners and how not to get re-infected if you do get treated and are cured. Hepatitis C treatment DOES work just fine though in people who use alcohol as long as the medications are taken as directed without missing doses.

There are many factors to consider before embarking on hepatitis C therapy with boceprevir/peginterferon/ribavirin for someone dually infected with HIV and hepatitis C genotype 1. I suggest that you consider fibroscan or liver biopsy before making a decision to start treatment with boceprevir/peginterferon/ribavirin. The benefits are likely to outweigh concerns if your liver has moderate to severe scarring. If have no scarring or mild scarring, it may be helpful to discuss with your doctors waiting for interferon-free therapy, and waiting for easier, safer medications. There can be medication interactions between boceprevir and some medications used to treat HIV, so it is important to discuss this with your doctors. Boceprevir interacts with other types of medications, in addition to HIV medications, so this is important to consider with your doctors if you are taking any of these other medications. Ideally, HIV infection should be well-controlled before starting treatment with boceprevir/peginterferon/ribavirin. Having a non-detectable HIV viral load is beneficial for HIV and hepatitis C infections.



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