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Date Posted: 19:15:17 07/24/02 Wed
Author: moonotter
Subject: HCV Coinfection Does Not Affect Outcome in HIV Infection

HCV Coinfection Does Not Affect Outcome in HIV Infection


Laurie Barclay, MD
Medscape Medical News 2002. © 2002 Medscape


July 8, 2002 — Coinfection with hepatitis C virus (HCV) does not adversely affect the outcomes from treatment with highly active antiretroviral therapy (HAART) for HIV, according to a presentation on July 6 at the XIV International AIDS Conference in Barcelona, Spain. Physicians should therefore treat coinfected patients as aggressively as those without HCV infection, the investigators suggest.
"In the U.S. and Europe, it is estimated that one in three of HIV-infected persons are also infected with hepatitis C and many of them are injection drug users," Glen R. Hanson, Acting Director of the U.S. National Institute on Drug Abuse, says in a news release. "Research needs to continue to determine best approaches to treating those who are coinfected with HIV and hepatitis C."

Between January 1995 and January 2001, 1,955 HIV-infected patients without an AIDS diagnosis enrolled in this study, including 873 patients (44.6%) with HCV seropositivity. The latter group was older, more likely to be African-American and to have a history of intravenous drug abuse than those who were HCV seronegative.

During the study, 1,199 patients were prescribed HAART, including 54% of the HCV-seropositive patients and 67% of the HCV-seronegative patients.

Physicians may be less likely to prescribe HAART to patients infected with both HCV and HIV for fear of liver complications, explains lead author Mark S. Sulkowski, MD, from Johns Hopkins University in Baltimore, Maryland. In this study, fewer patients with HCV seropositivity had received HAART, resulting in relatively high incidences of AIDS and death in this group.

In a subgroup of 429 HCV-seropositive patients with baseline CD4 cell counts between 50 and 200 cells/mm3, risk of death was increased (relative hazard ratio, 1.51, 95% confidence interval, 1.01-2.27). However, after correction for differences in exposure to effective HAART among HCV-seropositive and HCV-seronegative patients, HCV seropositivity was not independently associated with CD4 cell decline, death, progression to AIDS, or immune reconstitution after HAART.

Although the authors acknowledge various study limitations and the need for additional research, they conclude that "these findings emphasize the importance of effective antiretroviral therapy among HCV infected and uninfected persons at immediate risk for the development of AIDS."

XIV International AIDS Conference. July 6, 2002.

Reviewed by Gary D. Vogin, MD





Laurie Barclay, is a staff writer with WebMD.

Medscape Medical News is edited by Deborah Flapan, an associate editor at Medscape. Please send press releases and comments to news@webmd.net.
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