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Inteferon free treatment HVC/HIV co-infected (type 1A)
May 1, 2014

Doctor, I've been reading all the good news about new interferon-free treatments, but they all seem to be for type 2 and 3. What about those of us co-infected with 1a or 1B?

I'm treatment naive and hope to wai until interferon-free treatment is available-will that be soon?

Thanks very much!

Response from Dr. Taylor

There is a lot of good news.

Sofosbuvir plus simeprevir for 12 weeks with or without ribavirin is already available in some locales. Cure rates are over 90% across a range of patient subpopulations. This is a safe, well-tolerated regimen, just 2 pills per day if you take without the ribavirin. There are drug interactions between HIV meds and simeprevir which limits this option for many people. There are many drug interactions beyond HIV meds, with simpeprevir. Don't take St. John's wart with sofosbuvir (don't take St. John's wart in general, too many unsafe drug interactions).

There are many new meds being considered by the U.S. FDA, for those of you in the U.S. For example, Abbvie, BMS and Gilead medications are under review.

There is some excellent information in the public domain. Google AASLD, or go to http://www.aasld.org/Pages/Default.aspx. Click on Practice Guidelines, then Online Expert HCV Advice Now Available. Read the Full Report or click on the link HCVguidelines.org. There is a section under SPECIAL POPULATIONS for people with both HIV and HCV. This is developed by world experts in hep C, with support from the CDC and International AIDS Society, no industry/drug company input. The recommendations will be updated over time. If you have cirrhosis or kidney disease read these sections too. It can get a bit complicated so ask your doctor if you can review. I pull up these guidelines and discuss with my patients as we make decisions.

Remeber to talk with your doctor about whether or not you have cirrhosis, or advanced scarring. If so, try to get treated sooner not later, if possible.

The future looks bright. All best to you.



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