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Reuters Health Information (2008-08-26): Study supports prompt HCV therapy in HIV/HCV-coinfected patients


Study supports prompt HCV therapy in HIV/HCV-coinfected patients

Last Updated: 2008-08-26 15:46:45 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Patients coinfected with hepatitis C virus (HCV) and HIV often exhibit low levels of HCV neutralizing antibodies, which could contribute to a poorer outcome of HCV infection, a French study indicates.

"These results favor starting HCV therapy as soon as possible in coinfected patients," Dr. Gilles Duverlie from Hopital Sud, Amiens, and colleagues conclude in the August 1st issue of The Journal of Infectious Diseases.

Dr. Duverlie and colleagues retrospectively determined HCV neutralizing antibody titers in 37 HIV/HCV-coinfected patients and compared these values with those found in 37 patients with HCV monoinfection. The patients were matched on the basis of sex, age, and HCV genotype.

"A group of patients with well-controlled HIV infection was selected," the researchers explain, "and HIV disease in all was at a stage at which HCV therapy could either be started or, if hepatitis C has not progressed, delayed. In this context, the potential role of HCV neutralizing antibodies was evaluated by measuring HCV viremia in both groups of patients."

According to the researchers, a third-generation HCV neutralization assay showed a significantly lower mean HCV neutralizing antibody level among HIV/HCV-coinfected patients than among HCV monoinfected patients (p = 0.013).

The coinfected population also had a greater prevalence of undetectable HCV neutralizing antibody levels.

In this study, "anti-HCV antibodies production seemed already impaired by HIV infection, even in coinfected patients for whom HIV infection was well controlled by HAART and HIV viremia was not present," Dr. Duverlie and colleagues point out.

"In the context of HIV coinfection, our results highlight the weakness or even the absence of an HCV neutralizing antibody response during chronic HCV infection," they add.

These results, the investigators conclude, "provide an additional argument that efficient HCV antiviral therapy should be started as soon as possible in HIV-infected patients in order to improve the chance of eradicating HCV."

J Infect Dis 2008;198:332-335.

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