Clinical

Most men with HIV/HCV coinfection respond to early HCV treatment

Last Updated: 2010-12-03 16:06:06 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Acute hepatitis C should be treated early in HIV-infected men who have sex with men (MSM), French researchers say.

Hepatitis C virus (HCV) usually won't clear spontaneously in these men, but many of them will have a sustained response to therapy, the researchers report in the November 9th online issue of Hepatology.

The eradication rate in these patients following early HCV therapy is slightly above 80%, said lead author Dr. Lionel Piroth in email to Reuters Health.

Dr. Piroth of CHU Dijon and colleagues note that in recent years there has been an increase in HCV infection in HIV patients, and particularly in MSM.

Their paper has retrospective data on 53 co-infected men. The cumulative rate of spontaneous HCV clearance was 11% at 3 months and 16.5% at 6 months.

Forty patients were treated for a mean of 39 weeks; 38 men received pegylated interferon and ribavirin. Half of treated patients had undetectable HCV RNA by 4 weeks.

In all, 82.9% achieved a sustained virological response. The results did not appear to be associated with any particular characteristics, including HCV genotype.

"Pegylated interferon and ribavirin seem to be the best option, with a short (24 week) duration of treatment for patients presenting a rapid virological response and a longer (48 week) course for those who do not," Dr. Piroth said.

The encouraging response rate in these patients "could swing the pendulum toward immediate or at least earlier treatment of acute hepatitis C," the research team concludes.

SOURCE: http://link.reuters.com/nab58q

Hepatology 2010;52:1915-1921.