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Coinfection

National Viral Hepatitis Roundtable Applauds National AIDS Strategy's Recognition of HIV/HCV Coinfection

The National Viral Hepatitis Roundtable (NVHR) praised the inclusion of hepatitis B and C coinfection in the White House Office of National AIDS Policy's National HIV/AIDS Strategy released last week, given that an about 30% of HIV positive people also have HCV and approximately 10% also have HBV. The advocates also expressed hope that the administration will take a similar comprehensive approach to hepatitis B and C monoinfection, the latter of which affects about 4 times as many people as HIV.

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HIV/HCV Coinfected People with Insulin Resistance Do Not Respond as Well to Interferon-based Therapy

After controlling for other risk factors, insulin resistance was an independent predictor of poor response to interferon plus ribavirin combination therapy for chronic hepatitis C in people with HIV, according to a Spanish study published in the June 23, 2010 Journal of Acquired Immune Deficiency Syndromes. The researchers suggested that management of insulin resistance may enhance response rates in the HIV/HCV coinfected population.

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EASL 2010: HIV and Hepatitis C Virus Coinfection May Increase Death of CD4 T-cells

Dual infection with HIV and hepatitis C virus (HCV) may promote heightened apoptosis, or programmed death, of CD4 T-cells, according to a poster presented last month at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) in Vienna. This may help explain the finding in some studies that HIV/HCV coinfected people tend to experience more rapid HIV disease progression and have smaller CD4 cell gains on antiretroviral therapy (ART) than those with HIV alone.

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Liver Steatosis in People with HIV/HCV Coinfection

HIV positive people with chronic hepatitis C virus (HCV) coinfected do not appear more likely to have hepatic steatosis, or fat accumulation in liver cells, than HIV positive individuals, according to a meta-analysis reported in the July 2010 issue of Hepatology. The analysis also saw no association with any class of antiretroviral drugs.

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EASL 2010: Child-Pugh Score Changes Do Not Predict Liver Failure among HIV/HCV Coinfected Patients during Hepatitis C Treatment

Changes in Child-Pugh score, a clinical measure used to indicate the level of liver damage and risk of hepatic decompensation, may not reliably predict liver failure in HIV positive people with chronic hepatitis C virus (HCV) coinfection, since changes in the component parameters may be due to other causes, according to a poster presented at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) this month in Vienna.

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HIV/HCV Coinfection Does Not Impair Virological or Immunological Response to Antiretroviral Therapy

HIV positive patients coinfected with hepatitis C virus (HCV) achieved HIV viral load suppression and CD4 cell recovery on antiretroviral therapy similar to that of people with HIV alone, according to a study from China described in the June 1, 2010 Journal of Acquired Immune Deficiency Syndromes. Coinfected individuals with detectable HCV antibodies and HCV RNA, however, appeared more likely to experience certain antiretroviral side effects.

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EASL 2010: Biopsy Study Suggests Liver Disease Does Not Progress Faster in HIV/HCV Coinfected People

A poster presented last week at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) in Vienna suggests that HIV/HCV coinfection may not significantly accelerate liver fibrosis progression compared with HCV alone. This biopsy study adds to a conflicting body of evidence about the impact of HIV on hepatitis C pathogenesis.

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EASL 2010: Pegylated Interferon plus Ribavirin Works as Well in HIV/HCV Coinfected Patients with Cirrhosis

HIV/HCV coinfected patients with cirrhosis who received standard chronic hepatitis C therapy using pegylated interferon plus ribavirin had a sustained virological response rate similar to that of non-cirrhotic coinfected patients, according to research presented at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) last month in Vienna.

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HIV/HCV Coinfection Fell along with Injection Drug Use among Men in HOPS; WIHS Women Appear Prone to HCV Sexual Transmission

Two recently published studies looked at the epidemiology of HIV/HCV coinfection in large, long-term cohort studies. Among men in the HIV Outpatient Study (HOPS), the HIV/HCV coinfection rate declined between 1996 and 2007, corresponding to a drop in the proportion of new HIV infections attributable to injection drug use. In the Women's Interagency HIV Study (WIHS), however, a considerable number of women who acquired hepatitis C virus (HCV) did not inject drugs but had partners who did, suggesting that sexual transmission occurs more often than previously assumed.

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