Hepatitis coinfection: two major studies published.Two large clinical trials on treating hepatitis C Hepatitis C Definition Hepatitis C is a form of liver inflammation that causes primarily a long-lasting (chronic) disease. Acute (newly developed) hepatitis C is rarely observed as the early disease is generally quite mild. in patients also infected with HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. (1,2) were published July 29, 2004, in the New England Journal of Medicine The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. . The results were already known because they had been presented at the 2004 Retroviruses conference (abstracts #110 and #112). The new publication provides much more detail--and more credibility when it is necessary to advocate for payment from insurance companies or public agencies (including prisons) for patients with HIV who need treatment for hepatitis C (many who have hepatitis C do not need treatment, at least not immediately). Often two articles in peer-reviewed journals are demanded by payers to establish that a treatment is standard of care (meaning that refusing to consider it is probably malpractice). Now we have the two articles--in the medical journal usually considered the most prestigious in the U.S. An August 4 summary by AIDS writer Liz Highleyman, "Final APRICOT and ACTG ACTG Acting ACTG AIDS Clinical Trial Group ACTG Actuating/Actuator 5071 HIV/HCV Coinfection Results Published," is available at Aidsmap, http://www.aidsmap.com (try searching for APRICOT). This is a place to start for understanding these trials and what they mean for treatment of hepatitis C. An editorial in the Perspective section of the same issue of New England Journal of Medicine, "Treating Hepatitis C in 'Difficult-to-Treat' Patients" includes important background about the disease, causes of treatment failures, and prospects for major improvement in hepatitis C treatment over the next five to ten years. The text of this editorial is at http://www.natap.org/2004/HCV/080404_02.htm The abstracts of the two studies are available at http://content.nejm.org/content/vol351/issue5/index.shtml References (1.) Torriani FJ, Rodriguez-Torres M, Rockstroh JK, and others. Peginterferon Alfa-2a peginterferon alfa-2a Pegasys Pharmacologic class: Interferon Therapeutic class: Biological response modifier Pregnancy risk category C FDA Boxed Warningplus Ribavirin ribavirin /ri·ba·vi·rin/ (ri?bah-vi´rin) a broad-spectrum antiviral used in the treatment of severe viral pneumonia caused by respiratory syncytial virus, particularly in high-risk infants; also used in conjunction with interferon for Chronic Hepatitis Chronic hepatitisLong lasting inflammation of the liver due to viruses or other causes. Mentioned in: Tube Compression of the Esophagus and Stomach chronic hepatitis C Virus Infection in HIV-Infected Patients. New England Journal of Medicine. July 29, 2004; volume 351, number 5, pages 438-450. [This is the APRICOT study.] (2.) Chung RT, Andersen J, Volberding P, and others. Peginterferon Alfa-2a plus Ribavirin versus Interferon Alfa-2a plus Ribavirfin for Chronic Hepatitis C in HIV-Coinfected Persons. New England Journal of Medicine. July 29, 2004; volume 351, number 5, pages 451-459. [This is the ACTG A5071 study.] |
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