Early treatment of acute hepatitis C required in HIV–infected patients
Acute hepatitis C continues to be a concern in men who have sex with men, and its optimal management has yet to be established.
Dr Lionel Piroth and colleagues from France investigated the clinical, biological, and therapeutic data of 53 human immunodeficiency virus (HIV)-infected men who have sex with men included in a multicenter prospective study on acute hepatitis C in 2006-2007.
The team retrospectively collected and analyzed the data.
The mean hepatitis C virus viral load at diagnosis was about 6 IU/mL.
The cumulative rates of spontaneous hepatitis C virus clearance were 11% and 17%, at 3 and 6 months after diagnosis, respectively.
On treatment, 82% achieved sustained virological response
Hepatology
The researchers reported that 40 patients were treated, 38 of whom received pegylated interferon and ribavirin.
The mean duration of hepatitis C virus therapy was 39 weeks.
On treatment, 50% of patients had undetectable hepatitis C virus RNA at week 4, and 82% achieved sustained virological response.
The research team observed that sustained virological reponse rate did not correlate with pretreatment parameters, including hepatitis C virus genotype, but correlated with hepatitis C virus RNA at week 4, and with effective duration of hepatitis C virus therapy.
Dr Piroth's team concludes, "The low rate of spontaneous clearance and the high sustained virological response rates argue for early hepatitis C virus therapy following diagnosis of acute hepatitis C in HIV-infected men who have sex with men."
"Pegylated interferon and ribavirin seem to be the best option."
"The duration of treatment should be modulated according to hepatitis C virus RNA at week 4, with a 24-week course for patients presenting RVR and a 48-week course for those who do not, irrespectively of hepatitis C virus genotype."
Hepatol 2010: 52(6): 1915–2114
December 2010
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