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hep c coinfection with hiv
Jul 28, 2013

Sir I have been hiv positive since 1997 when i was detected with Hep C genotype 3.At the moment I am on second line HAART drugs for hiv and my viral loads are below 150 and cd4 counts vary from 470 to 400.I do my renal function tests and lft,cbc and hiv load and cd4 tests every 6 months.My last viral load for hep C(MARCH 2013) was 518,163 IU/ml lakh and alpha feto protein 6.97ng/mL.I have HCV GENOTYPING RT PCR AS genotype 3.What does this mean?Does this mean I have genotype 2? I heard from my hepatologist that interferon treatment has many side effects and a medicine called sufusbuvir may be available from 2014 around april.Can I wait till then or should start treatment with interferon immediately.

Response from Dr. Young

Hello and thanks for posting.

Today is World Hepatitis Day. Many people who have viral hepatitis don't know their status. The US Centers for Disease Control has a quick, terrific tool to see if you are at risk.

Your tests indicate that you have genotype 3 (not 2) HCV. Current HCV treatments can be very effective. Treatments still do involve the somewhat bothersome interferon. IFN does have side effects, but many thousands of people have taken it, and know that IFN treatment can be curative.

Current HCV protease inhibitors are indicated for genotype 1 virus, but probably not effective against genotype 3.

Sofosbuvir is an investigational HCV treatment that might not require interferon for the treatment of all genotypes. It's appears to be well tolerated, but the effectiveness for genotype 3 HCV may be lower than with other strains.

As for when to start treatment- this depends much on the current health of your liver. A liver biopsy or Fibroscan can determine the extent of liver injury; if none, it's probably ok to wait a little while (with monitoring). On the other hand, if you have evidence of liver scarring or fibrosis, waiting might put your health (and response to treatment) in jeopardy.

I hope that helps, BY



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