A new research examining the effectiveness of current HCV therapies revealed HIV patients coinfected with certain genotypes of Hepatitis C are harder to treat, a report on health news site Healio.com said.
The report, which cited data presented at a conference on Hepatitis C in New York, revealed HIV-HCV coinfected patients carrying "unfavorable HCV genotypes" (1a, 3 and 4) were more resistant to new direct-acting antivirals. The same is true for those suffering from advanced liver fibrosis and do not respond well to peginterferon, the report added.
Researchers found through a retrospective study that some 50 percent of HIV patients that were receiving antiretroviral treatment at a Madrid clinic never received treatment for HCV. Meanwhile, 44.7 percent of patients were either prescribed a combination of HCV drugs pegylated interferon and ribavirin or a combination of boceprevir and telaprevir. Researchers noted that most of the treatment-naïve patients decided not to receive treatment due to "alcohol abuse, neuropsychiatric disorders and decompensated cirrhosis."
Researchers profiled hundreds of HIV-positive persons for the study. They found that only thirty percent of 161coinfected patients responded to HCV treatment.
The conference was organized by the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of Liver (EASL), The Olive Press reported. According to AASLD's website, the conference gathered top epidemiologists, drug makers and clinicians from across the globe to develop groundbreaking and accessible therapies for HCV infected persons.
Treatment programs for HCV and HIV coinfected patients are widely available. Additionally, most health care providers are equipped with resources for HCV-HIV patient care. However, a lack of consensus-driven recommendations among clinicians for implementing proper HCV treatment could undermine the overall success of HCV-HIV coinfection treatment, two researchers maintained.
"HCV treatment guidelines for coinfected patients are published, but there is a lack of consensus regarding key factors that might inform initiation and duration of therapy, including stage of HIV and HCV disease and viral load, HCV genotype, degree of hepatic fibrosis, and patient's readiness to tolerate and adhere to treatment," Eva Operskalski and Andrea Kovacs, the study's authors, wrote.
"These have clinical importance because they influence safety, tolerability, and success of therapy. Investigations continue to identify better predictors of treatment response that could guide the pretreatment evaluation process and permit earlier termination of ineffective treatment, reducing additional cost and adverse effects of ineffective therapy," the authors said.
Operskalski and Kovacs added that clinicians should also look further into designing treatment plans for coinfected children.
HCV accelerates cirrhosis, decompensated liver or end stage liver disease faster in individuals with HIV than in non-HIV-infected people. Aids.gov noted that while medications have prolonged the life of people with HIV, HCV-caused liver disease "has become the leading cause of non-AIDS-related death among people living with HIV."
Twenty-five percent of the total number of HIV-infected persons in the United States has Hepatitis C. Because Hep C is transmitted through blood contact, coinfection is more prevalent-about 50 to 90 percent-among injection drug users (NYSEARCA:IDU).
Treating patients with coinfection is a continuous challenge for clinicians because of its risks. For this reason, the U.S. Public Health Service and the Infectious Diseases Society of America emphasize on screening HIV patients for HCV infection before recommending them to go into therapy.
Fortunately for coinfected patients, therapies are underway to help them protect themselves from viralogic failures while managing both HIV and HCV. For example, PRO 140, a humanized monoclonal antibody that is being developed by Cytodyn, Inc. (OTCQB: CYDY), has been found to work effectively well on patients with compromised organ function such as HCV coinfected persons. Because it is an antibody and not a drug, PRO 140 is not toxic to patients receiving HIV or HCV treatment. PRO 140 is a "fast track" product candidate of the U.S. Food and Drug Administration (FDA).
PRO 140 allows HIV patients to stop their HAART regimen without viral rebound. In a 40-patient clinical trial, PRO 140 was able to demonstrate the ability to prolong drug holidays in patients for four weeks while controlling their viral load.
Data from the Spanish government stated that two-thirds of HIV-infected persons in the country are also infected with Hepatitis C, The Olive said. Worldwide, around 4 to 5 million people are HIV-HCV coinfected.