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Drug Combo May Halt Liver Disease in Those With HIV/Hepatitis C

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WEDNESDAY, July 28 (HealthDayNews) -- An estimated 30 percent of HIV patients are also infected with hepatitis C, a dangerous double whammy that leaves them at higher risk for liver disease.

However, doctors have been wary of treating hepatitis C for fear it would compromise any ongoing HIV treatment. But now new research suggests a drug used for hepatitis C can actually help those who are HIV-positive.

"This is good news and reassuring," said Dr. Jack Stapleton, director of the University of Iowa HIV Program and an expert on hepatitis.

Like HIV -- the virus that causes AIDS -- hepatitis C is transmitted through the blood. But it's more difficult to become infected with hepatitis C through sexual contact. Most of those who develop the disease get it from intravenous drug use or blood transfusions, Stapleton said.

Hepatitis C can cause chronic liver disease and cirrhosis -- scarring of the liver. It leads to death in an estimated 1 percent to 5 percent of patients, health experts estimate. HIV infection appears to quicken the progress of liver disease in hepatitis C patients.

In the new study, which appears in the July 29 issue of the New England Journal of Medicine, scientists challenged the conventional wisdom that only one disease can be treated at a time.

Drawn from 19 countries, 868 patients infected with both HIV and hepatitis C took part in the three-year study, which was funded by the pharmaceutical company Roche. They all received interferon drugs with or without ribavirin, an anti-viral medication.

The patients who took one of the interferon drugs -- weekly injections of peginterferon alfa-2a -- plus ribavirin did the best. In 40 percent of them, the hepatitis C virus seemed to disappear and the HIV treatments were not affected.

"These people have now been cured of hepatitis and don't have to worry about the viral infection," said study co-author Dr. Francesca Torriani, an associate professor of medicine at the University of California, San Diego.

While interferon drugs often cause serious side effects, only 15 percent of the patients in the study had to stop taking them, she added.

Still, hepatitis C remains a difficult disease to treat. Even in HIV-negative patients, treatment only works about half the time, Stapleton said. Since the hepatitis C drugs can be toxic, more work needs to be done to determine which patients would benefit most from treatment, he said.

More information

To learn more about hepatitis C, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Jack Stapleton, M.D., director, University of Iowa HIV Program, Iowa City; Francesca Torriani, M.D., associate professor; medicine, Antiviral Research Center, University of California, San Diego School of Medicine; July 29, 2004, New England Journal of Medicine
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