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Coinfection

CROI 2010: HIV/HBV and HIV/HCV Coinfected People with Impaired Liver Function and Inflammation Have Higher Risk of Non-AIDS Death

HIV positive study participants with hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfection who had higher blood levels of biomarkers associated with impaired liver function and inflammation were more likely to die of non-AIDS-related causes, researchers with the SMART treatment interruption trial reported last month at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) in San Francisco.

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CROI 2010: More Evidence of Rapid Liver Disease Progression in HIV/HCV Coinfected People, but Antiretroviral Therapy Lowers Risk

A study from Spain adds to the evidence that liver fibrosis due to hepatitis C virus (HCV) infection may progress unusually fast in people with HIV. However, the investigators reported at the 17th Conference on Retroviruses and Opportunistic Infections (CROI 2010) last month in San Francisco, effective antiretroviral therapy (ART) that suppresses HIV and raises CD4 cell count reduces the risk of liver disease progression.

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Elevated ALT Liver Enzymes in HIV Patients without Hepatitis B or C Are Linked to High Viral Load, Obesity, Alcohol, and Some NRTIs

Among HIV positive individuals without coexisting hepatitis C virus (HCV) or hepatitis B virus (HBV) infection, the incidence of persistent elevated ALT levels was 3.9 cases per 100 person-years, researchers reported in the February 15, 2010 issue of Clinical Infectious Diseases. The risk of ALT elevation was greater in people with high HIV RNA levels, higher body mass index (BMI), heavy alcohol use, and prolonged use of stavudine (d4T; Zerit) or zidovudine (AZT; Retrovir).

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CROI 2010: Leakage of Gut Bacteria Linked to Poor Hepatitis C Treatment Response in HIV/HCV Coinfected Patients

HIV/HCV coinfected individuals who did not respond well to interferon-based therapy for hepatitis C showed evidence of greater microbial translocation -- leakage of bacteria due to HIV damaging the gut -- than early responders, although T-cell activation did not differ, according to a poster presentation at the 17th Conference on Retroviruses & Opportunistic Infections (CROI 2010) last week in San Francisco.

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Larger Viral Decline during Hepatitis C Treatment in HIV/HCV Coinfected People with Favorable IL28B Pattern

HIV/HCV coinfected patients with the C/C IL28B gene pattern experience larger decreases in hepatitis C virus (HCV) levels during the first phase of viral decline after starting treatment with pegylated interferon plus ribavirin, and were more likely to achieve virological response, researchers reported in the December 19, 2010 advance online edition of the Journal of Acquired Immune Deficiency Syndromes. A similar effect was seen for second-phase viral decline in people with HCV genotype 1, but not genotype 3.

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Does Liver Fibrosis Progress Faster in People Who Have HIV When They Acquire Hepatitis C?

HIV positive men who subsequently became infected with hepatitis C virus (HCV) appeared to have a suspiciously rapid rate of liver disease progression in the European NEAT study, according to a poster presented at the 17th Conference on Retroviruses & Opportunistic Infections (CROI 2010) this week in San Francisco. The researchers suggested that apparent fast progression might be attributable to short duration of follow-up.

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Factors that Influence the Decision of HIV/HCV Coinfected Patients to Start Treatment for Hepatitis C

It is estimated that nearly 30% of HIV positive people are coinfected with hepatitis C virus (HCV), and liver disease is a leading cause of death in this population. However, only a small number of HIV/HCV coinfected patients receive treatment for hepatitis C due to a variety of factors, according to an article published in the November 22, 2009 online edition of AIDS Patient Care and STDS.

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HIV/HCV Coinfected Veterans Have Elevated Risk of Chronic Kidney Disease

HIV positive people coinfected with hepatitis C virus (HCV) are more likely to have chronic kidney disease than individuals with HIV alone, and kidney disease is linked to significantly greater risk of death, according to a study of U.S. veterans described in the February 2010 Journal of Acquired Immune Deficiency Syndromes.

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Nearly One-third of HIV/HCV Coinfected Patients with Normal ALT Have Liver Fibrosis that Indicates Treatment

HIV positive individuals coinfected with hepatitis C virus (HCV) are more likely than HCV monoinfected patients to have a degree of liver fibrosis that justifies treatment, even if they have persistently normal alanine aminotransferase (ALT) levels, according to study reported in the November 2009 Journal of Viral Hepatitis.

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