Coinfection Chronicle

hepatitis C virus successfully treated with a triple-drug antiretroviral regimen are no more likely to experience rapid liver disease progression than adults infected only with HCV, according to a study in the January 15 edition of the journal Clinical Infectious Diseases. The researchers say early initiation of anti-HIV therapy reduces necroinflammation, which results in slower progressing and less severe liver disease. HIV coinfection can increase levels of hepatitis C virus in the bloodstream by 2- to 8-fold, French researchers reported in the November issue of the Journal of Hepatology. HIV-HCV coinfection also accelerates the risk of cirrhosis and of the rare but deadly condition fibrosing cholestatic hepatitis, they said. A study of nearly 5,000 HIV patients showed no evidence that any specific anti-HIV drug may be more poorly tolerated than others and lead to treatment discontinuation in study subjects also coinfected with HCV. Writing in the journal Antiviral Therapy, the researchers said their analysis has shown that while HIV-HCV'coinfected adults were more likely to quit therapy because of drug-related toxicity than those infected only with HIV, toxicity issues were not related to any specific anti-HIV medication. Blood-based levels of hepatitis C virus can predict the risks for end-stage liver disease and death in both patients infected only with HCV and in HIV-HCV'coinfected adults, according to a study in the December issue of the journal Hepatology. As HCV levels in the blood increased, so did the risk of death from end-stage liver disease, according to the study of nearly 400 HCV patients. Markers of liver damage that can be detected in the blood provide an accurate picture of the extent of liver disease in HIV-HCV'coinfected adults, according to a study in the December 15 edition of the Journal of Acquired Immune Deficiency Syndromes. They said their findings suggest these tests could be used in place of expensive and invasive liver biopsies. The FDA approved the hepatitis C treatment Ribasphere in December. The drug, jointly marketed by Par Pharmaceutical and Three Rivers Pharmaceuticals, is available in 200-, 400-, and 600-milligram tablets for use in combination with interferon alfa-2a. The FDA has granted fast-track review status to Vertex's experimental hepatitis C treatment VX-950. A Phase Ib study of the drug has shown it had significant and rapid virus-lowering effects. A Phase II U.S. study is expected to begin this year. Pharmaceutical firms Idenix and Novartis in January filed for FDA approval of their hepatitis B treatment telbivudine. A clinical trial including more than 1,300 hepatitis B patients showed telbivudine was more effective in suppressing HBV in the bloodstream than standard lamivudine therapy. Some hepatitis B test kits manufactured by Johnson & Johnson were recalled in January because of higher than normal odds of returning false-positive results. Three defective lots of the Vitros Immunodiagnostic HBsAG Confirmatory Kit had been distributed in Europe and the United States. Johnson & Johnson officials say they are unaware of anyone receiving an inaccurate diagnosis, but they urge health care facilities to review previous test results.