Better Way Found to Treat Hepatitis C in HIV Patients

Researchers have identified a better way to treat chronic hepatitis C in patients who are also infected with HIV. 

A report in the July 29 issue of New England Journal of Medicine shows that the preferred treatment for hepatitis C alone is also safe for patients with both hepatitis C and HIV. 

"Not long ago, treating HIV patients for hepatitis C was an afterthought, because they usually died of AIDS before developing complications from hepatitis C," said Kenneth Sherman, MD, PhD, director of the UC Division of Digestive Diseases and co-author of the article.  "But with the advent of better anti-HIV medications," he said, "these patients are living longer and are more susceptible to complications from hepatitis C."

Until recently the accepted treatment for hepatitis C/HIV was standard interferon, a group of proteins from white blood cells that prevent a virus from spreading, plus the antiviral drug ribavirin.

But when standard interferon was replaced with a variant known as peg-interferon-which stays in the body longer-the response in hepatitis C/HIV-infected patients was so dramatic that peg-interferon became the preferred treatment.

Prior to this study, limited data were available on the benefit and safety of peg-interferon and ribavirin in HIV-infected people.

Implications of this study are huge. Anti-HIV drugs are helping HIV patients to live longer, but as a result, they are more likely to suffer complications from hepatitis C-including severe liver damage resulting in the need for transplant. UC is participating in a study to design proper protocol for liver transplants in HIV patients, but finding a better treatment for hepatitis C may eliminate the need for this costly procedure in some patients.

The Centers for Disease Control and Prevention (CDC) estimate that hepatitis C infects about 25,000 Americans annually and is responsible for about 8,000 to 10,000 deaths per year. Some 3.9 million Americans have been infected with hepatitis C, 2.7 million of whom are chronically infected, according to the CDC. It is also estimated that of the 1 million HIV-infected Americans, about 300,000 are also infected with hepatitis C.

The study was funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Center for Research Resources (NCRR), both agencies of the National Institutes of Health (NIH). NIAID's Adult AIDS Clinical Trials Group conducted the study at 21 research centers in the United States.

Roche Laboratories provided study medications and participated in the protocol team.