Coinfection Chronicle

Patients coinfected with HIV and hepatitis C virus should not combine the anti-HIV drug Videx with hepatitis treatments peginterferon alfa-2B and ribavirin, according to a study in the September 1 issue of the journal AIDS. The combination of the medications creates a 46-fold increase in the risk of developing severe--and potentially fatal--mitochondrial toxicity, French researchers reported. __________ Current guidelines may be premature in calling for anti-HIV drug therapy to be stopped in HIV-HCV'coinfected patients even if liver function tests suggest rising toxicity levels, researchers reported in the October 15 edition of Clinical Infectious Diseases. Their study has shown that while levels of the liver enzyme ALT can spike after antiretroviral treatment begins, they commonly return to baseline levels after 48 weeks of treatment, allowing drug treatment to continue uninterrupted. __________ An ongoing study of nearly 6,000 HIV patients has shown no difference in the overall incidence of AIDS-defining illnesses or death among study participants coinfected with HCV and those who were free of hepatitis C. Deaths from liver-related problems were higher among the coinfected patients, but the researchers reported in the September 15 edition of the Journal of Infectious Diseases that this was related solely to hepatitis infection, not HIV disease. __________ Although medical guidelines call for HIV patients to be vaccinated against hepatitis B, only one out of every six vaccinations given to HIVers results in an antibody response strong enough to prevent hepatitis infection, researchers reported in the October 1 issue of Clinical Infectious Diseases. British researchers discovered that vaccine recipients with an HIV viral load below 400 copies benefited from the vaccine; patients with higher viral loads were not protected against HBV. __________ Women who are coinfected with HIV and HCV experience more neuropsychological problems than women infected with only HIV, only HCV, or who are free of both diseases, researchers reported in the October 14 edition of AIDS. Women with CD4-cell counts below 200 were at the highest risk of brain impairment, according to the study of 220 women.