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Author Topic: hiv meds that mitigate hcv  (Read 1736 times)

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Offline next2u

  • Member
  • Posts: 1,762
hiv meds that mitigate hcv
« on: July 19, 2009, 08:56:22 PM »
hello,

for those of us who are co-infected which hiv meds or med combos have shown promise in delaying hcv progression? my hcv viral load is low. my doctor and i will be having a conversation real soon about this and i wanted to be prepared.

i know that it is good to start meds while my tcell count is relatively high. i hear this also will keep my hcv load lower if my immune system is robust. i have also heard that certain hiv medications/regiments have a positive affect on hcv.

any insight is appreciated.

best,
d
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5

Offline Tempeboy

  • Member
  • Posts: 358
  • Like St Francis of Assisi I am wedded to Poverty
Re: hiv meds that mitigate hcv
« Reply #1 on: July 20, 2009, 01:14:04 AM »
Here is a cool resource from ibase in the UK - http://www.i-base.info/guides/hepc/
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline edfu

  • Member
  • Posts: 1,084
Re: hiv meds that mitigate hcv
« Reply #2 on: July 20, 2009, 05:49:27 AM »
What do you do to help prevent transmission of your hepatitis C to your sexual partners? 
"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Offline next2u

  • Member
  • Posts: 1,762
Re: hiv meds that mitigate hcv
« Reply #3 on: July 20, 2009, 07:19:14 AM »
the same thing they do to help reduce the chance of transmission to themselves. talk about it and make a decision based upon what is acceptable to us. i dunno, what do you think?

tempeboy - thanks for the link, much appreciated.
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5

Offline Inchlingblue

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  • Chad Ochocinco PETA Ad
Re: hiv meds that mitigate hcv
« Reply #4 on: July 20, 2009, 12:21:26 PM »
This is a good site for info on HIV/HCV co-infection

LINKS:

http://www.hivandhepatitis.com/hiv_hcv_co_inf_articles.html

http://www.hivandhepatitis.com/

You can also ask Dr. Gallant what he thinks and/or search his site for already existing Q & A's on the subject.

LINK:

http://www.hopkins-hivguide.org/q_a/index.html?categoryId=9352&siteId=7151
« Last Edit: July 20, 2009, 05:05:54 PM by Inchlingblue »

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: hiv meds that mitigate hcv
« Reply #5 on: July 20, 2009, 01:46:43 PM »
Hi D,

Are you sure you aren't thinking of hep B? Epivir and Tenofovir have both been proven effective against hbv and Emtricitabine is being used experimentally.

From what I understand, the recommendation is to treat the hcv before starting on hiv meds, if the hiv infection is stable with good numbers - like yours. None of the drugs used to treat hiv have any effect on hcv, and can cause further damage to the liver. That's why they like you to treat the hcv first, and alone if possible.

My doctor and I both think that my successful treatment of hcv is at least partly responsible for my still not being on hiv meds. Since the hcv treatment, my hiv VL has been low. In the six years since hcv treatment, my hiv VL went to 40,000 once and 29,000 once, but other than that it's usually in the teens of thousands, sometimes going as low as 3,000. Before treatment, it was anywhere between 90,000 and 21,000, never lower than 21,000.

If I were you, I'd be seriously talking to my doc about treating the hcv NOW, while your hiv numbers are still so good.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline next2u

  • Member
  • Posts: 1,762
Re: hiv meds that mitigate hcv
« Reply #6 on: July 20, 2009, 05:18:27 PM »
thanks ann,

yeah, i wasn't sure which hiv meds helped reduce the activity of hcv and i didnt' know that it was specific to the type of hcv.

my dr has not suggested treatment yet because my hcv viral load is low. im also not on meds but my numbers are trending downward. i have an appt with him next monday and we will talk about both options. honestly, im scared shitless of hcv treatment and will postpone it as long as possible.

my viral load is around 16 thousand and my tcells are like 415. i dont remember the exact numbers but it still indicates a slow decline.

thanks for the advice.

best,
d
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5

Offline Ann

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  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: hiv meds that mitigate hcv
« Reply #7 on: July 20, 2009, 07:21:12 PM »
d,

Hepatitis C (hcv) and hepatitis B (hbv) are two totally different types of viral hepatitis. All hepatitis means is liver inflammation.

None of the hiv meds do a thing against hep C. Two and possibly three work against hep B.

Even if your hep C viral load is low, it's worth treating because it's not going to go away. If you treat now with a low VL, you have a better chance of beating it. It's not a nice treatment, but why wait to do it until after you've had to go on the hiv meds? It would be so much easier on you now.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Luke

  • Member
  • Posts: 291
Re: hiv meds that mitigate hcv
« Reply #8 on: July 21, 2009, 02:32:25 AM »
Basically what Ann said - plus the fact that it is actually more a case of which HIV meds you don't want to be on (i.e. will lower the chances of any Hep C treatment working).

Should we spare the nukes? NRTI HIV drugs may impair success of hepatitis C treatment  http://aidsmap.com/en/news/E25328C5-59B2-43B4-BC3A-3B6364C5158D.asp
« Last Edit: July 21, 2009, 04:32:20 AM by Luke »

Offline markaj

  • Member
  • Posts: 80
Re: hiv meds that mitigate hcv
« Reply #9 on: July 21, 2009, 03:41:58 AM »
That is a low Hep c viral load but I'd probably still try and clear the virus with treatment.  That's what I did.  I wanted to take control of it and not have to wait until my hand is pushed.  I've just completed a 24 week course and after a good few lousy weeks I've been fine.  The side effects weren't as bad as I prepared myself for.  Even if you do hold off and end up taking treatment side by side with HIV meds that's more than doable with well tolerated HIV meds, so you can afford to think lots and not rush into anything you're not ready for.
Infected Jan 08 / diagnosed Feb 08
Feb 08 - CD4 230 (9%) VL 3.5 million
Mar 08 - CD4 440 (6%) VL 660.000
Apr 08 - CD4 420 (11%) VL 3 million
Jun 08 - CD4 200 (7%) VL 3 million
Started Kaletra/Truvada Jul 08
Jul 08  - CD4 250 (14%) VL 23.893
Aug 08 - CD4 410 (15%)  VL 4.313
Switched to Sustiva/Truvada Aug 08
Switched to Reyataz/Norvir/Truvada Sep 08
Diagnosed with Hep C, HIV meds stopped for a bit
Nov 08 - CD4 414 (12%) VL 500.000+
Started Isentress/Truvada Nov 2008
Dec 08 - CD4 381 (17%) VL 1.116
Jan 09 - CD4 534 (20%) VL <50
Started Interferon/Ribavirin Jan 09
Feb 09 - CD4 407 (24%) VL <50
Mar 09 - CD4 360 (28%) VL <50
Apr 09 - CD4 279 (30%) VL <50
Jun 09 - CD4 298 (36%) VL <50
Aug 09 - CD4 303 (35%) VL <50

Offline newt

  • Member
  • Posts: 3,878
  • the one and original newt
Re: hiv meds that mitigate hcv
« Reply #10 on: July 21, 2009, 09:18:34 PM »
Quote
i wasn't sure which hiv meds helped reduce the activity of hcv

No HIV meds affect Hep C, except to say combo is a good idea cos it slows progression of hep c it seems.

To do or not to do pegelated interferon + ribavarin is a moot point, some will do, some will wait, the risk/benefit analysis is not as clear cut as ARVs.

The "official" time to clear Hep C and not therefore count as a chronic infection is 6 months.But some peopl do clear it, eg after a year. There's no way of knowing. Generally with Hep C, treatment earlier = greater chance of success.

- matt
"The object is to be a well patient, not a good patient"

 


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