HIV And HCV Co-Infection: A Serious Medical Problem


Taken on their own, both Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) can be deadly. Combined, they are one of the most serious health threats that an individual can face. Unfortunately, HIV and HCV co-infection is also a relatively common problem due to the fact that both diseases share same sources of transmission. Between fifteen and thirty percent of patients with HIV infection are also suffering from HCV. Exposure to infected blood, sexual intercourse, and mother to child transmission can all spread each disease simultaneously. In worst case scenarios, HCV infection can progress beyond self-limiting status and lead to liver cirrhosis and cancer.

HIV is the virus that causes AIDS and wreaks havoc on the body by destroying the immune system, raising the susceptibility to other infections and diseases. HCV infection is a serious problem that attacks the liver, and can eventually lead to death if left untreated. Due to the HIV infection, those with HCV co-infection display higher rates of disease progression, drug interactions, and many other problems caused by the combination of the two conditions. Recent studies, however, have shown promise in the area of treatment against HCV. These studies have shown that management of HCV infection can be better than it once was.

Obviously, treatment of HCV infection holds an ultimate goal of curing the disease. In other words, total eradication of the virus within the body is possible with HCV. This outcome is still unreached, however, in about half of co-infection cases due to lower rates of response. In these patients, treatment focuses on reducing the risks of liver failure and cancer, while awaiting for new therapeutic agents. HCV infection cure is achieved mainly through the use of a combination of 2 drugs known as pegylated interferon and ribavirin.

In HIV and HCV co-infected patients, not only the rates of response are lower but the occurrence of adverse side effects is increased. Around twelve percent of the patients undergoing treatment are forced to stop it due toxicities like depression, anemia, decrease in white blood cells. New kinds of drugs against HCV are awaited in 2011, named the Protease inhibitors, which are very active against the virus. They will still have to be administered in combination with pegylated interferon and ribavirin, but for a shorter period of time. They also have their own toxicities, such as cytopenia and allergies, but will greatly increase the response rates.

Therapeutic options are moving this year for co-infected patients. Even if HIV infection cannot be cured, more patients will get rid of HCV.

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International Symposium on HIV & Emerging Infectious Diseases (ISHEID):

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Boceprevir Or Telaprevir For HIV-HCV Co-Infected Patients


An exciting development for HIV-positive patients who are co-infected with hepatitis C just recently occurred: Two new medications, boceprevir and telaprevir, were recommended to be approved by the FDA for treating hepatitis C. While this is a new development, several uncertainties remain for those co-infected with HIV and HCV (an acronym for the hepatitis C virus). Both boceprevir and telaprevir are HCV protease inhibitors, and while they are potent, interaction with anti-HIV medications is cause for concern. Both drugs were approved based on studies done on mono-infected patients; that is, patients who were infected with hepatitis C only.

In those who were just infected with hepatitis C, adding boceprevir and telaprevir to the standard 48-week HCV treatment raised cure rates from the normal average of 40 to 45 percent to a much higher 65 to 80 percent. This is a remarkable jump. However, for those who also have HIV, the picture isn’t quite as clear. Normally, the cure rates using the standard program are lower in co-infected patients. Tests on both of these drugs in co-infected patients are ongoing and won’t be complete until mid- to late-2012. Preliminary results for one of the drugs-telaprevir–are promising though. 70 percent of those co-infected who received telaprevir in addition to the normal HCV treatment had undetectable HCV levels

Results are still inconclusive, of course, since more testing is yet to be done. The side effects of boceprevir and telaprevir, which are normally rash and anemia, could be more pronounced in co-infected HIV-HCV patients; further testing will conclude whether or not these side effects occur and their severity in the co-infected patients. Drug interactivity must also be looked at. There may be interactions between the antiretroviral medication that HIV-positive patients take and HCV medications-especially telaprevir.

The new drugs have renewed interest in getting HIV-positive people tested for HCV in the immediate future so treatment can commence quickly. HIV and HCV have things in common in that they’re both spread through unprotected sexual contact, the sharing of needles, and other such exchanges of bodily fluids. The co-infected have a possible additional avenue to explore for their HCV treatments; however, any such talk of an effective cure is still years away. After all, more testing needs to be done on these drugs if they have any chance at winning FDA approval. Researchers may be on the cusp of finding something that can cure HCV in patients who are co-infected with HIV.

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International Symposium on HIV & Emerging Infectious Diseases (ISHEID): the world leading AIDS experts will gather for the 2012 HIV AIDS ISHEID conference in Marseille, France, May 23-25, 2012. The general AIDS conference theme will be ‘From Universal HIV Testing to HIV Cure’.

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