Coinfection Chronicle

Researchers in Canada report progress in crafting a vaccine containing 10 different proteins that could prevent hepatitis C infectionless likely to adhere to their anti-HIV drug regimens than those only infected with HIV, according to a study in the February 14 edition of the journal AIDS. Canadian researchers, studying 1,186 HIVers found that HCV coinfection was a risk factor for adherence failure, defined as taking less than 95% of anti-HIV medications as prescribed. Male HIVers also were less likely to be adherent. An increase in ribavirin dosage may help improve responses to hepatitis C treatment in HIV-HCV coinfected adults, according to studies presented at the Second International Workshop on HIV and Hepatitis C Coinfection. Adjusting the dosage of ribavirin'marketed as Copegus, Rebetol, and Virazole'based on a patient's weight is more effective in controlling HCV than standard 800-milligram-per-day dosing, according to French researchers. Fatigue is commonly misdiagnosed as depression among HIV-HCV coinfected patients receiving anti-hepatitis drugs, according to a study by New York researchers. Depression is a common psychological side effect of hepatitis C therapy and a major reason treatment is halted. But the scientists reported at the Second International Workshop on HIV and Hepatitis C Coinfection that fatigue, usually caused by anemia, is more than twice as prevalent during HCV treatment than depression, but is commonly misdiagnosed. Measuring levels of ALT, an enzyme that is a marker of liver function, may be an inaccurate gauge of liver disease in HIV-HCV coinfected adults, according to a study in the January 1 edition of the Journal of Acquired Immune Deficiency Syndromes. Researchers found that 25% of patients with normal ALT levels actually had such severe liver damage that they required hepatitis treatment, with 13% having developed cirrhosis-related liver scarring. A study of 50 Spanish HIV patients who've undergone liver transplants due to hepatitis coinfection shows that the procedure is safe and effective in the short- and mid-term. The study showed that survival rates were 85% after one year, 75% after two years, and 66% after three years, levels similar to those seen in HIV-negative hepatitis patients who received liver transplants. Long-term success of hepatitis C therapy among HIV-HCV coinfected adults can be predicted by the early response to anti-hepatitis drugs after just four weeks of treatment, according to a study presented at the 13th Conference on Retroviruses and Opportunistic Infections. Among study patients who achieved a rapid virologic response to the medications, 95% maintained viral suppression through 24 weeks of treatment and 90% maintained suppression for at least another 24 weeks after drug therapy was stopped. Among those with a slower response to the drugs, only 69% achieved viral control by the end of the 24-week treatment period and only 37% maintained virologic suppression through the 24-week post-treatment follow-up.