October #95 : HEP Or HIV? - by David Gelman, MD

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Table of Contents

The Clock Watchers

After Ibn Zuhur

Stayin’ Alive: A Game Plan

I Wanna New Drug!

In Cold Blood

Unfine China

Maine Idea

Bayer's BIG Headache

Neg & Pos

Gone Shopping

The Bug Stops Here

Milestones

Documania

For Pete's Sake

Wake-Up Call

Heavenly & Hazardous

Shock and Blah

Publisher's Letter

Mailbox

O Lady Liberate:

O Cash up Front:

Tastes Great! Less Filling!

Tat Caveat

Only A Test

Lipodystrophy

New Meds On The Shelf

Book Report

60% of HIVers Now Survive Lymphoma

Zip Your Lipids

Tea Cells

Paris When It Sizzled

Playing It Safe And Sexy

HEP Or HIV?

The Soprano

Dementia

Butch And Moan

Toxic Avengers



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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October 2003

HEP Or HIV?

by David Gelman, MD

Hiv/hepatitis C coinfection poses a dilemma: Which virus should be treated first? U.S. docs often choose HIV, trying to shore up the immune system to better the hep C treatment’s chance of success. But in a study of 105 HIVers at Milan’s Vita-Salute San Raffaele University, those treated first for hep C got a leg up on their HIV treatment—and had less HAART-related liver damage. Although most of these Europeans had a highly treatable hep C strain—while most U.S. heppers have the harder-to-treat genotype 1—liver pro Douglas Dieterich, MD, of New York City’s Mt. Sinai med school says, “The Milan news applies here.” Why? Because treating hep C slows liver damage even if it doesn’t clear the virus. Dieterich adds that treatment priorities vary from patient to patient: Is the immune system weaker than the liver? Treat HIV first. Liver worse? Vice versa. As hep C treatments become more effective and easier on the body, taking them first may become the rule, protecting the liver from future HAART attack.



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