Treat co-infected HIV patients for hepatitis C
In Europe, some 30 per cent of patients with HIV infection are co-infected with hepatitis C virus. At present, few patients receive treatment for hepatitis C but a European consensus statement issued last week emphasises the importance of treatment.
Use of highly active antiretroviral therapy has led to a reduction in
traditional opportunistic infections in HIV-infected patients and liver
disease has become an increasing cause of mortality. The consensus was
developed by an independent jury after a two-day conference. “The
most important part of our statement is the need to increase the number
of patients treated for hepatitis C because the disease can potentially
be eradicated,” said jury co-president Nathan Clumeck, of Saint-Pierre
University Hospital, Brussels.
The statement says that the recommended treatment for hepatitis C co-infection
is a combination of peginterferon alfa and ribavirin. It does not distinguish
between peginterferon alfa-2a and alfa-2b, both of which have been shown
to be effective in co-infection trials, although cure rates are not as
high as in hepatitis C monotherapy. The current advice is to treat for
48 weeks.
The need to manage side effects to reduce premature discontinuation of
therapy is emphasised. Further trials are required to define optimum
duration of treatment and dosages, and whether maintenance interferon
can reduce disease progression in patients who do not achieve cure.
The statement, which also covers hepatitis B co-infection, is expected
to be published in Hepatology.
Pegasys (peginterferon alfa-2a; Roche) has recently received a licence
for use in patients with hepatitis C who are co-infected with HIV.
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