Sixth International Congress Drug Therapy in HIV Infection 17-21 November, 2002 Glasgow, UK

In Europe, it is estimated that approximately 30% of HIV-infected individuals are coinfected with HCV. HCV coinfection is even higher (50% to 90%) among high risk groups such as intravenous drug users and hemophiliacs. The rate of perinatal as well as sexual transmission of HCV appears to increase in HIV coinfection.

HIV accelerates HCV liver disease, especially when HIV-associated immune deficiency progresses. Within 10-15 years of initial HCV infection, 15% to 25% of patients who are coinfected with HIV develop cirrhosis compared with 2-6% of patients without HIV infection. Moreover, hepatocellular carcinoma appears to occur at a youger age and after shorter duration of hepatitis C infection in HCV-coinfected individuals.

With the introduction of pegylated (PEG) interferon promising new treatment options have become available for HIV/HCV-coinfected patients. End-of-treatment results of ongoing trials with PEG-interferon and ribavirin combination therapy show up to 50% virological treatment response (defined as negative HCV-RNA-PCR). In case of HAART and hepatitis therapy interactions between ribavirin and nucleoside analogues have to be considered. If possible concomitant use of ddI or AZT and ribavirin should be avoided in order to prevent additional bone marrow toxicity (AZT) and to lower the risk for lactic acidosis (ddI).

The high number of HIV/HCV-coinfections, as well as the much more unfavourable course of hepatitis C in these patients, underline the need for establishing treatment strategies for hepatitis C in HIV-coinfected individuals.

Conclusions: Jürgen Rockstroh

Presenting author:

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1 Department of Medicine I, University of Bonn, Germany.

2002-11-17
PL10-2

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