Sustained Virological Response after Early Antiviral Treatment of Acute Hepatitis C Virus and HIV Coinfection

Abstract

Anti-HIV and -HCV therapy should be considered early in cases of concomitant acute HCV and HIV coinfection, because successful therapy of HCV viremia seems possible even during primary HIV infection. HCV-specific T cell immunity is generated during primary HIV infection and can be preserved by HCV treatment. However, the optimal treatment algorithm needs to be established in prospective, randomized trials.

Broadly directed virus-specific CD4+ T cell responses are primed during acute hepatitis C infection, but rapidly disappear from human blood with viral persistence

“…Lymphocyte proliferation assays were performed as described previously (Day et al, 2002; Lauer et al, 2002) using c22.3, c33c, c100.3, C200 and NS5 HCV proteins (Chiron) at concentrations of 10 µg/ml (Day et al, 2002). CFSE proliferation assays were performed as previously described (Lichterfeld et al, 2004; Kasprowicz et al, 2008; Schulze Zur Wiesch et al, 2009). Where indicated, IL-2–neutralizing antibodies (clone MQ1-17H12; BD) or isotype control antibodies (clone A4A; Neomarkers) were added at 10 µg/ml.…”

Guidelines for the management of hemophilia

“… Assessment of HCV in people with hemophilia should include: anti-HCV serology to determine exposure HCV polymerase chain reaction (PCR) in those who are anti-HCV positive HCV genotyping in those who are HCV PCR positive liver function tests and non-invasive assessment of fibrosis and liver architecture The current standard of treatment for HCV is pegylated interferon (PEG-INF) and ribavirin, which give sustained virological response in 61% of people with hemophilia. (Level 1) [ ] New antiviral therapies, in combination with these drugs, may improve sustained virologic response rates. [] HCV genotype 1 and HIV coinfection predict poorer response to anti-HCV therapy. Where HCV eradication cannot be achieved, regular monitoring (every 6–12 months) for end-stage liver complication is recommended.…”

HIV/HCV Co-infection: Pathogenesis, Clinical Complications, Treatment, and New Therapeutic Technologies

“…RVR had a 100% positive predictive value, suggesting that RVR is an important predictor of SVR in acute and chronic HCV infection. Results for three patients suggest that an SVR is possible even during primary HIV infection [106]. …”