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NATAP REPORTS |
SUMMER 2001 |
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Current Review & Update on Hepatitis C & HIV/HCV C o Infection |
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Published & Edited by Jules Levin |
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Introduction --Similarities and Differences between HCV and HIV Epidemiology --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 Conclusions |
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). Get our Hepatitis C & Hepatitis C/HIV Co-Infection Handbook ! |
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