CROI 2009: High HCV Viral Load Is Associated with an Increased Risk of Death in HIV-HCV Coinfected Individuals

In contrast with HIV, most studies to date indicate that hepatitis C virus (HCV) viral load is not associated with disease progression. But this may not be the case for HIV-HCV coinfected individuals, according to a study presented at the 16th Conference on Retroviruses and Opportunistic Infections (CROI 2009) last month in Montreal.


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CROI 2009: British Study Finds HIV-HCV Coinfected Patients Do Not Have Impaired CD4 Cell Recovery after Starting HAART

Studies to date have produced conflicting data on the question of whether HIV-HCV coinfected individuals experience slower or less extensive CD4 cell recovery after starting antiretroviral therapy (ART). 

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Boosted Atazanavir (Reyataz) and Etravirine (Intelence) Are Safe and Well-tolerated in Patients with Hepatitis B or C Coinfection

Antiretroviral therapy (ART) may cause liver toxicity, indicated by elevated liver enzymes, and studies have shown that this is more likely to occur in HIV positive individuals with hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfection. Two studies presented at the recent 9th International Congress on Drug Therapy in HIV Infection in Glasgow, Scotland, looked at the safety of 2 newer antiretroviral drugs in patients with hepatitis B or C.

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CROI 2009: Antiretroviral Treatment Interruption May Affect HCV Viral Load, HBV Rebound, and Liver Fibrosis Progression in Coinfected Patients

Over the past few years, evidence has accumulated showing that antiretroviral treatment interruption is a potentially risky strategy, and that ongoing HIV replication is associated with a variety of non-AIDS conditions even in people with relatively well-preserved immune function.

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ICAAC 2008: HAART Is Associated with Reduced Liver Inflammation in HIV-HCV Coinfected Patients

Several past studies have shown that HIV positive people with chronic hepatitis C virus (HCV) coinfection tend to experience more rapid and perhaps more severe liver disease progression, leading some experts to suggest that such patients should perhaps start interferon-based therapy sooner.

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Adequate Ribavirin Level Promotes Sustained Response to Interferon-based Therapy for HIV-HCV Coinfected Patients

Ribavirin plays an important role in preventing relapse after completion of interferon-based therapy for chronic hepatitis C. But this treatment does not work as well in HIV/HCV coinfected people, and the effects of ribavirin in this group are not fully understood.

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ICAAC 2008: Drug Interaction Observed between NRTI Tenofovir (Viread) and Experimental Hepatitis C Protease Inhibitor Telaprevir

Due to overlapping risk factors, many people are coinfected with some combination of HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV). Treating patients with more than one virus involves additional complications, including the potential for drug interactions. In a poster presented at the 48th International Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2008), taking place this week in Washington, DC, researchers from Tibotec described a study looking at interactions between the company's experimental HCV protease inhibitor telaprevir (VX-950) and the widely prescribed anti-HIV drug tenofovir (Viread, also in the Truvada and Atripla combination pills), which was also recently approved as a treatment for chronic hepatitis B.

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Advanced Liver Disease in People with HIV

As HIV positive people live longer due to effective antiretroviral therapy, liver disease has become an increasingly important cause of illness and death in this population.

In some cases, advanced liver disease in people with HIV is related to coinfection with hepatitis B or C virus (HBV or HCV), certain antiretroviral drugs are known to cause liver toxicity, and in other cases the cause of liver disease is unclear. Three presentations at the recent 9th International Congress on Drug Therapy in HIV Infection (HIV9) in Glasgow discussed end-stage liver disease (ESLD), advanced liver fibrosis, and severe portal hypertension in HIV-infected individuals.

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Detectable HCV in Peripheral Blood Cells after Interferon-based Therapy Predicts Relapse in HIV-HCV Coinfected Patients

Traditionally, individuals treated for chronic hepatitis C virus (HCV) infection who maintain undetectable HCV RNA (genetic material) in their blood 6 months after completing therapy are defined as achieving sustained virological response (SVR). It is not clear how the presence of HCV in the liver and elsewhere in the body affects the likelihood of sustained treatment response versus relapse, especially in HIV positive people.

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