Reuters Health Information (2004-05-25): HCV relapses more common in patients with HIV
HCV relapses more common in patients with HIV
Last Updated: 2004-05-25 11:50:47 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Almost one third of HIV patients with hepatitis C virus (HCV) co-infection showed signs of relapse following discontinuation of apparently successful anti-HCV therapy, Spanish researchers report in the April issue of AIDS Research and Human Retroviruses.
"To reduce relapses, prolonged periods of treatment may be necessary in HCV/HIV-co-infected patients," lead investigator Dr. Vincent Soriano told Reuters Health.
Dr. Soriano and colleagues at Instituto de Salud Carlos III, Madrid note that it is not clear whether the doses and duration of anti-HCV therapy should be modified in those with HIV co-infection.
To investigate, the researchers studied 58 such co-infected subjects. They had undetectable levels of HCV-RNA at the end of anti-HCV therapy with standard or pegylated interferon and ribavirin. Patients with HCV genotypes 2 and 3 were treated for 6 months, and those with genotypes 1 and 4 had 1 year of therapy.
However, within 6 months of discontinuation of treatment, 19 (32.8%) relapsed. This proportion, say the investigators, is significantly higher than the failure range of 15% to 20% reported in patients without HIV co-infection.
The researchers conclude that extended periods of anti-HCV therapy might improve the outcome in patients with HIV and they call for trials to study this approach.
"The duration of therapy might be tailored by HCV genotype," Dr. Soriano added, "and we propose 12 months for HCV genotypes 2 or 3, and 18 months for genotypes 1 or 4."
AIDS Res Hum Retroviruses 2004;20:351-353.