Coinfection Chronicle

A double dose of a commonly used vaccine is more effective at preventing hepatitis B infection among HIV-positive adults than the standard single dose, researchers from Brazil report in the journal Vaccine. Nearly half of the study subjects given a double vaccine dose posted significant increases in hepatitis B'specific antibodies, compared to 34% of those given a single dose. Double dosing is particularly effective for HIV patients with CD4-cell counts above 350 and HIV viral loads below 10,000. __________ It might be possible to safely stop anti'hepatitis C drugs after just half the recommended course of treatment, researchers report in The New England Journal of Medicine. Patients who have no detectable blood-based levels of hepatitis C virus after 12 weeks of Peg-Intron and Rebetol treatment can stop at that point instead of at the standard 24-week mark, Italian researchers say. Drug side effects also were significantly lower in patients who stopped HCV therapy early. __________ Sexual transmission of hepatitis C virus among HIV-positive gay men in Paris was shown to be linked with sex acts that can lead to bleeding in the anus, including unprotected anal intercourse, rough anal intercourse, and such practices as fisting, according to a study in the June edition of Eurosurveillance Monthly. Mucosal lesions associated with other sexually transmitted diseases that can lead to anal bleeding also can boost HCV infection risks, researchers report. __________ Adults coinfected with HIV and hepatitis C who have high baseline levels of a key liver enzyme and low levels of a liver protein are at a higher risk of experiencing hepatitis-related liver toxicity while taking anti-HIV medications, researchers report in the July edition of the Journal of Viral Hepatitis. High pretreatment aspartate aminotransferase and low albumin levels are linked with abnormally elevated liver enzyme levels and eventual liver damage, according to the study of 85 coinfected adults. __________ French researchers report in the June issue of the Journal of Hepatology that liver disease is now a top cause of death among adults coinfected with HIV and hepatitis. A study of the records of coinfected patients who died in 2000 in France showed that 31% of deaths among HIV-HCV coinfected patients was linked to liver disease, with 29% of deaths tied to AIDS-related complications. Twenty-two percent of HIV-HBV coinfected patients who died were killed by liver disease. Although triple coinfection with HIV, HCV, and HBV was rare, these patients were at the highest risk of death from liver disease.