I'm not that up on co-infection but in general when people are co-infected the HCV can pose an equal or perhaps greater threat than the HIV.
Success rates are not as good for co-infected groups. I am not up on the treatment protocols but you stand an excellent chance of beating the HCV virus if you stay the course. It would not surprise me if the treatment times would be extended longer than a basic geno 2 infection, not further complicated with HIV. Due to what could be diminished immune response it could be that as a group HIV patients have a lower response rate and/or a higher relapse rate. I feel your doctor is just figuring that a bit longer treatment offers you a greater chance at success and that if successful your prognosis with "only" the one virus will be greatly improved.
There could be some studies which can verify this over at hivandhepatitis(I think ).com
check out this site, stay on the coinfected forum and perhaps do a search of ;
coinfection, genotype 2
mj, i'm not quite familiar with coinfections, however, i do know, that for hcv genotypes 2 & 3, people usually treat for 24 weeks.
Thanks,I'll check it out.
The majority (75%) of Genotype 2 without a HIV co-infection have a rapid viralogical response (RVR=und by wk 4 ).
The predictive factor for RVR g2 is 80-85%SVR., depending on what study you use.
Any G2 that do not RVR but have a early viralogical response (EVR=und by wk 12) have less chance of SVR ...iirr it goes down to 60-70% with a 24wk tx.
Here areG2 extended tx co-infected SVR rates.
Check table 3 on page 6... this is genotype2 Hcv+Hiv coinfected doing tx for 48wks
Unfortunately you did not RVR, are you taking full dose riba and ifn ?
IMO, your Dr is making a good decision extending tx for you, the Roche study/clinical trials extends co-infected to 48 wks
I'm taking more than full dose riba (600mg) and full dose ifn. My Dr did discuss 48 weeks but said new studies show less time is effective.I'm just mad and sick of it all. I feel like I'll have to decide how long. Thanks for your response apache.
I know of two people who are co-infected...they are brothers, don't know what gt. Both started tx...one went 48 weeks and beat HCV the other couldn't handle the meds and quit after one week.
I hope this encourages you to stay the course...you can beat the HCV....
I am currently enrolled in a Vertex trial. I asked my study nurse if there had been any research involving co-infected but she hadn't heard of any....yet
Just saying.....600 is not more than full dose at all. Many here are on 1200 or even 1400 weight based riba.
If you read this clinical Hiv+Hcv trial from Roche, they used flat dose 800 mg riba daily...not 600 and for 48 wks.
page 6 table #3
Your Dr is right, there have been new studies showing 16, and 12 wks work, but are slightly less effective. Geno2 _16wks tx has been approved in Europe.
BUT that is NOT co-infected
and is WITH RVR (und 4weeks)
and is with weight based riba. (800mg+)
and is with low VL at baseline
Thats at least 3 big criteria you do not have.
Has your Dr told you what his normal g2 tx for co-infection without rvr is ?
"I'm just mad and sick of it all. I feel like I'll have to decide how long."
Maybe a second opinion from another Hepatologist could help lessen your frustration with this.
Hang in there buddy, you will get this.
I am sure your Dr's will know what is best for you.
Thanks both....apache,your knowledge is great! I think a good talk with my Dr is what I will do, I want to be sure to do the right thing.I don't want to have to do this over again.
Hi mj - I am GT 3a & HIV coinfected. Luckily I achieved RVR at week 4 - at week 18 now and will do 24 weeks. Sounds like we started around the same time
This article just came out last week that reaffirms 24 weeks for coinfected w/ GT 2 or 3:
Also, this was from April:
My doc feels 24 weeks from first clear test is the way to go if you haven't cleared at week 4. But then again, their isn't much in the way of real scientific evidence to really know your probabilities. So you have to balance with quality of life issues.
I am co infected with HIV 25 years and Hepatitis C group 1a
the length of treatment time is the same as for all other hepatitis patients.
your response rate in the 4th and 12th week will determine the length of treatment,
Further depends on the levels of HIV virus as your doctor may decide to treat one before the other to get to suitable levels before HV treatment.