I would like to know when you would consider an HIV patient stable enough for HEP C therapy, i.e. cd4/VL related. In addition, would you consider patients for Interferon/Ribaviron therapy who has a psychiatric hx but stable on therapy.
 
Thanks, having a difficult time working with our hepatology re: some of our HIV patients that I believe might qualify and any information would be helpful.
 

 

Starting HCV Rx for pts with CD4 > 200 has generally been my threshold. if your pt is already on HAART, then it would be reasonable to consider adding in PEGIFN/RBV , but carefully. i would have your pt biopsied to be stage the liver dz. if it is very mild or minimal, you may even defer HCV Rx and follow. the stable psychiatric dx is the key, and we can successfully get pts through the treatment if they have a close line of communication with a mental health provider/PCP.