July 28, 2004 -- People infected with both hepatitis C and HIV can be safely and effectively treated with current hepatitis C therapies without compromising their HIV treatment, according to a new study.
Researchers say about a third of HIV-positive people are also infected with the hepatitis C virus, and infection with both viruses in people receiving antiviral therapy has been associated with an increased risk of complications and death. Hepatitis C infection may also affect the course and management of HIV infection, with some studies suggesting that certain types of hepatitis C are associated with more rapid progression to AIDS or death.
But two studies published in this week's New England Journal of Medicine show that a substantial proportion of people infected with both viruses can be safety and successfully treated with the interferon and antiviral drugs currently used to treat chronic hepatitis C alone.
Hepatitis C Treatment Works in People With HIV
Interferons are proteins that are released in the body in response to viral infections. Interferon drugs are used to help the body fight viruses, such as hepatitis C, and regulate the immune system. Ribavirin is an antiviral drug used in the treatment of hepatitis C and other infections, but the way the drug works is unknown.
In the studies, researchers compared the effectiveness and safety of different interferon drugs with and without ribavirin in treating more than 900 people infected with hepatitis C who were HIV positive.
The studies showed that the success rate of treatment with the interferon drug Pegasys plus ribavirin was higher than with other interferon drugs alone or in combination with ribavirin. About 40% of patients treated with this combination had a sustained response to treatment, compared with 12% treated with another interferon drug plus ribavirin and 20% with Pegasys alone. A sustained response was defined as finding no hepatitis C virus in the blood 24 weeks after treatment.
Researchers found that success rates varied according to the type of hepatitis C virus the patient was infected with. Those with genotypes 2 or 3 were about twice as likely to have a sustained response to treatment compared with those infected with genotype 1.
In a related perspective in the same journal, Jean-Michel Pawlotsky, MD, PhD, of the University of Paris XII in CrÃ©teil, France, says these studies show that many people infected with both HIV and hepatitis C can be successfully treated.
"These results, together with the poor prognosis for HIV-positive patients with [hepatitis C] infection, justify broad use of antiviral therapy in the treatment of coinfected patients," writes Pawlotsky.