National AIDS Treatment Advocacy Project


Current Review & Update on Hepatitis C & HIV/HCV Co Infection

Published & Edited by Jules Levin

--Similarities and Differences between HCV and HIV
--Epidemiology of HCV/HIV Coinfection
Pathogenesis of HCV
--Virology: Hepatitis C Genetic Diversity and High Level of Viral Replication Pose a Challange
--Immune Response; Immunnology: Strong CTL Response May be needed for Viral Eradication
--Immune Based Therapy
--Does HAART Affect Liver Disease Progress in HCV/HIV Coinfected Patients?

Management of HCV Infection
--Assessment of disease severity
--Role of Liver Biopsy in Hepatitis C

Treatment of HCV
--Goals of Therapy
--What is sustained virologic response (SVR)?
--Factors that predict a successful therapeutic response
--How is HCV treated

Current Review of Pegylated Interferon Data
--Comparing the two formulations of pegylated interferons
--Two studies find benefit in treating HCV during acute infection
--Suggested dosing of ribavirin by weight
--Adherence is crucial to HCV treatment success:apparently more so in genotype 1
--Initial viral load response may predict final viral response

Adverse Events, Safety, Tolerability and Quality of Life
--treatment,and adverse events associated with treatment as well as Achieving SVR Improves Fatigue, Quality of Life, General Well-Being & Functioning; Affect of HCV on the Brain, Fatigue, Hostility, and Anger
Treatment of Adverse Events
--Erythropoietin for interferon and ribavirin associated anemia
--Less Anemia with Pegasys Alone vs Standard IFNa-2b + Ribavirin

Other Issues in HCV Treatment
--Improved Histology and Maintenance Therapy; Improved Liver Condition for Nonresponders
--ALT does not correlate with hepatic inflammation or fibrosis
--Liver transplants in coinfection &HCV recurrence following liver transplantation
--Effect of Diet on HCV

Treatment of HCV in Special Populations
--Hard To Treat Populations: African-Americans, genotype 1 & 4, cirrhotics, nonresponders & relapsers
--Pegylated Interferon + Ribavirin for Interferon/Ribavirin Failures
--18 months therapy for hard to treat patients: cirrhosis; high viral load, genotype 1


This update and review includes information reported at recent Hepatitis Conferences: AASLD (American Association for the Study of Liver Disease, November 2000; June 2001), DDW (Digestive Disease Week, May 2001), EASL (European Association for the Study of Liver Disease, April 2001).

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The information in this newsletter is only for educational purposes. Before making any treatment decisions, one should consult with one’s doctor(s).

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