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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] S Hopkins, F Lyons, F Mulcahy, C Bergin
St James's Hospital, Dublin, Ireland
BHIVA Conf 2002 Apr 19-21;8:O30
BACKGROUND: With the advent of highly active antiretroviral therapy, the prognosis of HIV+ patients has altered. End-stage liver disease is an increasing cause of morbidity and mortality in those patients co-infected with HCV.
METHODS: All co-infected patients are followed at a designated treatment clinic. All patients are eligible if virologically suppressed with a CD4 count >200 cells/µL, or do not currently need HAART by current international guidelines and fulfil treatment criteria for HCV.
RESULTS: 16 patients (12 males, four females) have commenced therapy (mean age 37.9 years, range 28–49); 87.5% contracted HIV and HCV through intravenous drug use (IDU). Eight patients are currently on methadone maintenance therapy. 10 are genotype 3 and six are genotype 1. The mean biopsy score is 3.7/6. Side effects to date are flulike symptoms (100%), diarrhoea (8%), headache (64%), itchy/dry skin (32%) and alopecia (8%). The mean weight loss was 4.5 kg (range 2–10) over the first 4 weeks. Haematological side effects have occurred in all patients though only three required dose modification (thrombocytopenia, severe haemolytic anaemia). The mean haemoglobin (Hb) at baseline was 14.6 g/dL and fell to mean 11 g/dL at 4 weeks; the mean absolute neutrophil count fell from 2.67 to 1.8×109/L. One patient suffered severe haemolytic anaemia with a drop in Hb from 14.3 to 7.8×106/L. One patient discontinued therapy secondary to severe depression at week 10. 11 patients have >12 weeks on therapy. At week 12, five are HCV RNA– (all genotype 3); six are HCV RNA+ (three genotype 1; three genotype 3)
CONCLUSION: Any patient with Hb <10 g/dL is given erythropoietin (4000 IU subcutaneously weekly). Early response rates are low, primarily due to advanced HIV disease and prolonged HCV infection.
PRESENTING AUTHOR: S Hopkins
020419
O30
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD