Coinfection Chronicle

A study in the September issue of the American Journal of Gastroenterology shows that HIV'hepatitis C and HIV'hepatitis B coinfected patients report a similar overall quality of life as patients infected only with HIV. All of the study subjects reported similar scores for mental and physical health, the researchers noted. Hepatitis C virus is found much more frequently in the semen of HIV-HCV coinfected men than in those only infected with hepatitis, researchers reported in the November 4 issue of the journal AIDS. An analysis of semen samples from HCV-infected men showed that 38% of the samples from coinfected men had detectable hepatitis virus, compared to 18% of the samples from men infected only with HCV. The researchers theorize that HCV transfers between the blood and the semen more easily in HIV-positive men. HCV may be compartmentalized in the genital tracts of HIV-HCV coinfected women, where it replicates independently of virus in the bloodstream, according to a study in the November 1 issue of The Journal of Infectious Diseases. The researchers say HCV was detected in cervicovaginal fluids from 31% of coinfected women, compared to none of the women infected only with HCV. Although the researchers are unsure why virus was frequently detected in the genital tracts of coinfected women, they theorize that HIV and HCV may be infecting the same cells, resulting in increased HCV replication, or that HIV-related immune system damage may allow both viruses to more easily replicate. HCV infection in the brain could be linked with the development of neurological ailments in HIV-HCV coinfected patients, researchers report in the October issue of the journal AIDS. HCV has been detected in autopsied brain tissue, particularly in certain macrophages and microglia, raising the possibility that hepatitis could be directly linked to cognitive changes in coinfected patients. Shorter treatment of HCV infection with Pegasys and ribavirin may be possible for so-called 'super responders,' patients who achieve dramatically lowered blood-based viral levels after four weeks of treatment, researchers reported at the American Association for the Study of Liver Diseases conference. Super responders are able to successfully treat HCV with only 24 weeks of therapy, compared to the standard 48 weeks required for those responding more slowly to the medications, according to the study. A study in the November issue of the journal Hepatology has shown that Interleukin-12, while a common component of combination hepatitis B treatment, does stop HBV replication when dosed on its own. IL-12 did, however, boost the antiviral effects of Epivir, resulting in a greater increase in virus-specific T-cell activity and interferon-gamma production. The Schering Plough experimental hepatitis C treatment SCH 503034 has significant antiviral activity in HCV patients for whom standard Pegasys and ribavirin therapy is failing, researchers reported at the American Association for the Study of Liver Diseases conference. HCV viral load reductions were detected in study subjects within 24 hours of the first dose, and patients who received 400-milligram doses three times daily experienced the most significant drops in viral levels. VX-950, an experimental hepatitis C protease inhibitor in development by Vertex Pharmaceuticals, was shown in a Phase IB clinical trial to be well-tolerated and also to have substantial antiviral effects. Additional studies are planned to better gauge the compound's ability to inhibit HCV replication. Roche is expanding its large-scale study comparing hepatitis C treatment response rates between Latinos and whites to better fight HCV among the Latino population, where hepatitis infections are more common. Some studies also have shown HCV to progress faster to cirrhosis and liver failure in Latinos than in whites or African-Americans. Roche is expanding the study of Pegasys and Copegus (ribavirin) treatment to 60 trial sites in Puerto Rico and other parts of the United States.