Hepatitis C infection does not alter HIV progression or treatment

Resolving conflicting reports about the effect of hepatitis C virus infection on the progression of HIV disease, a Hopkins study of nearly 2,000 HIV patients shows that hepatitis C does not increase risk of death, accelerate the development of AIDS, or curb the value of antiretroviral HIV therapy.

Historically, and for unknown reasons, patients with hepatitis C are less likely to receive so-called highly active antiretroviral therapy, or HAART, than are those without hepatitis C, according to the report published in the July 10 issue of The Journal of the American Medical Association (JAMA), a theme issue on HIV/AIDS. Patients with both hepatitis C and HIV infections experience relatively high rates of AIDS and death. In the Hopkins study, these patients did just as well on HAART as patients with HIV alone.

"Among patients prescribed HAART, we found no evidence that hepatitis C virus infection substantially alters the virologic or immunologic response to potent antiretroviral therapy. Hepatitis C virus infection should not be a barrier to aggressive antiretroviral therapy in HIV patients," said lead author Mark Sulkowski, M.D., assistant professor of medicine in the division of infectious diseases, and medical director of the Center for Viral Hepatitis at Hopkins.

Scientists have known for some time that HIV can make hepatitis C worse and increase the progression of hepatitis C-related liver disease, but the verdict was out on how, and to what degree, hepatitis C affects HIV. In the United States and Europe, an estimated 16 percent to 30 percent of those with HIV also have hepatitis C due to shared methods of transmission, such as injection drug use. In Baltimore and other major cities, these numbers can be as high as 50 percent or more.

The Hopkins study included 1,995 patients enrolled between January 1995 and January 2001 at the Moore HIV Clinic of The Johns Hopkins Hospital. All were HIV positive but did not have AIDS when t

Contact: Trent Stockton
Johns Hopkins Medical Institutions

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