People co-infected with HIV and HCV, mostly with hepatitis C virus (HCV) genotype 3, responded about as well as HIV-negative people to interferon-based therapy after taking into account other factors associated with poor treatment response, according to an Italian study presented at the 53rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) this month in Denver. Advanced liver fibrosis was common in the co-infected group, supporting the need for early treatment.
An estimated one-third of HIV-positive people are co-infected with HCV, with higher rates in countries where the HIV epidemic is largely driven by injecting drug use. Over years or decades, chronic hepatitis C can lead to serious liver disease, including advanced fibrosis, cirrhosis and hepatocellular carcinoma. HIV/HCV co-infected people tend to experience faster liver disease progression and do not respond as well to interferon as people with HCV alone.
Paola Nasta from Spedali Civili di Brescia and colleagues compared treatment outcomes amongst HIV/HCV co-infected and HCV mono-infected people with HCV genotype 2 or 3 treated at their hospital between 2005 and 2010. Genotypes 2 and 3 have traditionally been classified as 'easier-to-treat' in comparison with 'harder-to-treat' genotypes 1 and 4.
This retrospective analysis included 113 HIV/HCV co-infected and 627 HCV mono-infected adults not previously treated for hepatitis C. About 85% of the co-infected participants and two-thirds of the mono-infected participants were men and the mean age was 45 years. All the HIV-positive participants were on antiretroviral therapy with undetectable HIV viral load and the mean CD4 cell count was 455 cells/mm3.
