Because many HIV-positive people with acute hepatitis C infection clear HCV without drug treatment, doctors should wait 12 weeks before initiating antihepatitis therapy, according to researchers in the United Kingdom. Of 50 coinfected men studied, 24% spontaneously cleared acute HCV infection within 12 weeks of hepatitis infection, the scientists report. Patients most likely to clear HCV were those with CD4-cell counts above 500 or those with a low HCV viral load.
Delaying HCV therapy would allow time for some patients to clear the hepatitis infection on their own, the researchers conclude.
The study also shows that HCV treatment is less likely to be effective in HIV-HCV coinfected patients than those with only HCV. Between 90% and 98% of those infected only with HCV responded well to pegylated interferon treatment, compared to just 59% of coinfected study subjects.
