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HCV Disease Progression

EASL 2010: HIV/HCV Coinfected Patients with Acute Hepatitis C Are Equally Likely to Achieve Sustained Response with Interferon plus Ribavirin

HIV positive people with acute hepatitis C treated with pegylated interferon plus ribavirin, and HIV negative people treated with pegylated interferon alone, had a similar likelihood of achieving rapid virological response (RVR) at week 4 and sustained virological response (SVR) after completing treatment, according to findings presented at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) last month in Vienna. RVR was the best predictor of SVR, but HIV/HCV coinfected patients had larger HCV viral load reductions between weeks 4 and 12, suggesting that ribavirin promotes "third phase" viral decline.

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Chronic Hepatitis C Complications are Increasing, Especially among People Older than 60 Years

The proportion of people with chronic hepatitis C virus (HCV) infection who will develop advanced liver disease including cirrhosis, decompensation, and liver cancer is likely to increase over the next 10-20 years as people infected decades ago reach the stage of developing advanced disease; these complications are expected to be especially common among people over age 60. But more widespread treatment could significantly lower projected rates of disease progression, according to a study published in the February 2010 issue of Gastroenterology.

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CROI 2010: Moderate Liver Fibrosis Predicts Disease and Death in HIV/HCV Coinfected People, but Successful Treatment Appears Protective

Even moderate liver fibrosis (greater than stage F1) in HIV/HCV coinfected patients is associated with adverse clinical outcomes including liver cancer, liver failure, and death, investigators reported at the 17th Conference on Retroviruses & Opportunistic Infections (CROI 2010) last week in San Francisco. However, effective HIV treatment producing long-term viral suppression and successful hepatitis C treatment leading to sustained virological response appeared to be protective.

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Antibiotic Rifaximin Maintains Remission of Hepatic Encephalopathy in People with Advanced Liver Disease

Treatment with the antibiotic rifaximin maintained remission from hepatic encephalopathy, or brain impairment, better than placebo in people with advanced liver disease, according to a report in the March 25, 2010 New England Journal of Medicine. The drug was well tolerated overall, and patients taking rifaximin were less likely to be hospitalized than placebo recipients.

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Liver Transplant Do Not Impair Immune Response in HIV/HCV Coinfected Patients

HIV/HCV coinfected patients who undergo liver transplantation do not lose immune responses to hepatitis C virus (HCV), HIV, or opportunistic infections, according to an analysis reported in the December 2009 Journal of Hepatology. This study adds to the evidence that appropriately selected coinfected individuals can be suitable candidates for liver transplants.

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