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10th Anniversary Conference Of The British HIV Association [BHIVA]15 – 17 April 2004, City Hall, Cardiff, UK |
[AUTHOR(S):] S Bhagani1, M Danta2, C Hui1, G Slapak2, G Dusheiko2, MA Johnson1
1 Department of HIV Medicine and 2 Centre for Hepatology, Royal Free Hospital, London, UK
BHIVA Conf 2004 Apr 15-17;10:O20
BACKGROUND: An epidemic of acute HCV has recently been recognised among HIV-positive men in London. We describe their virological outcomes and response to early treatment.
TREATMENT: All patients persistently positive for HCV RNA by reverse transcriptase polymerase chain reaction 12 weeks after presentation were offered peg-IFN-α2b (1.5 µg/kg) and ribavirin (>10.6 mg/kg) for 48 weeks.
RESULTS: 36 cases of acute HCV were identified (mean age 30.5 years, median CD4 count 514 cells/µl); 17 were on HAART. Genotype 1 infection was noted in 21 (58%), genotype 3 in seven (19%), genotype 4 in four (11%) and four could not be typed. In nine patients (25%), HCV cleared spontaneously. 16 patients started treatment [median CD4 514 cells/µl, median HCV viral load (VL) 5.86 log10, 12 genotype 1, three genotype 3, one genotype 4]. At week 12, 15 patients were evaluated: 11 (73%) achieved early virological response (HCV VL <50 iu/l or >2 log10 decrease), two were non-responders, one stopped therapy and one was lost to follow-up. Of the nine patients remaining at week 24, six (66%) had an undetectable HCV-RNA, one stopped treatment and two remain non-responders; two patients stopped therapy at 24–48 weeks and remain undetectable. At week 48, three patients achieved an end-of-therapy response.
CONCLUSIONS: Spontaneous clearance of HCV is possible, despite HIV co-infection. Initial results suggest a favourable response to early treatment despite unfavourable genotypes and high HCV viral loads.
PRESENTING AUTHOR: S Bhagani
040415
O20
Copyright © 2004 - 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