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The Body Covers: The 7th European Conference on Clinical Aspects and Treatment of HIV-Infection
Anti-Protease Inhibitor Therapy Decreases the Liver Fibrosis Progression Rate in HIV-HCV Co-Infected Patients

October 26, 1999

Authored by M. Bochet, Y. Benhamou, G. Colombet, et al.

Oral Abstract 248

This study explored what impact using effective anti-HIV treatment with protease inhibitors would have on those with hepatitis C. As there is much concern about what treatments should be used for this group, these data are potentially very important in guiding treatment decisions.

The study included 162 persons with hepatitis C and HIV infections. All underwent a liver biopsy to best document the impact of treatment on the course of hepatitis C in the liver, since the use of blood testing alone as a predictor of what is happening in the liver remains controversial. Most of the participants were men, with an average age of 37. The group had hepatitis C for an average of 14 years. The CD4 count was an average of 327, and viral load was about 18,000. Overall, 49 were taking a protease inhibitor for an average of 12 months prior to the biopsy. As expected, the group taking a PI had a lower viral load than those not using one.

More damage to the liver (fibrosis) was seen in those who were older, had more alcohol use, and had a lower CD4 count. Further analysis suggested that the two most important correlates of less fibrosis in the liver was a CD4 count over 200, and using a protease inhibitor to treat HIV infection. The duration of use of a PI also correlated with less fibrosis in the liver, which further strengthened this observation.

This study therefore suggests that treating the underlying HIV infection is important in those with hepatitis C. While the best regimen for those with hepatitis C remains unclear, this study provides information that treatment of the HIV infection is also better for slowing the damage done to the liver by the hepatitis C virus.

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