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TheBody.com/TheBodyPRO.com cover the XVIII International AIDS Conference (AIDS 2010)

Treatment of Co-Infection Despite Very Low CD4+ Cell Counts

October 25, 2010

In general, treatment guidelines for HCV-HIV co-infection encourage the initiation of HCV therapy at counts well above the 200 CD4+ cell level. The reason for this is that HCV therapy can temporarily reduce CD4+ cell counts, and if these fall too low there is a risk that life-threatening infections could develop.

Researchers in Barcelona and elsewhere in Spain conducted a pilot study to evaluate the safety of HCV therapy in co-infected people with low CD4+ cell counts. Their results are surprising and may incite the initiation of larger studies to explore the issue of HCV therapy in people with low CD4+ cell counts.


Study Details

Researchers recruited 11 co-infected volunteers, all who had HCV genotype 1 and who were taking anti-HIV therapy. None had hepatitis A or B or any other significant health condition. They were divided into two groups as follows:

  • Group A: 5 participants with an average of 150 CD4+ cells
  • Group B: 6 participants with an average of 450 CD4+ cells

All participants received standard treatment for HCV -- interferon and ribavirin adjusted according to body weight.


Results

Preliminary results of 12 weeks of therapy were made available:

  • Decreases in HCV viral load occurred and were similar in both groups.
  • Although the CD4+ count fell to an average of 133 cells among those in group A, no life-threatening infections occurred.
  • The CD4+ count among participants in group B (who began HCV therapy with higher CD4+ counts) fell to an average of 383 cells

Since no serious AIDS-related infections occurred and significant reductions in HCV viral load were seen, at least over the short-term, the Spanish researchers say that larger and longer studies are warranted in co-infected people with low CD4+ cell counts.


Reference

  1. von Wichmann MA, Crespo M, Rodriguez-Arrondo F, et al. Pilot study to evaluate safety and HCV kinetics in HCV/HIV co-infected patients with less than 200 CD4+, treated with peginterferon alfa-2b and ribavirin (P04675 study). In: Program and abstracts of the 18th International Conference on AIDS, 18-23 July 2010, Vienna, Austria. Abstract MOPE0178.



This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication TreatmentUpdate. Visit CATIE's Web site to find out more about their activities, publications and services.
 


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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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