Tack­ling virus early best tac­tic

The Weekend Australian - Travel - - Health - From Health cover

had data on their progress af­ter four weeks of treat­ment. Among the 26 pa­tients in­fected with HIV as well as hep­ati­tis C, RVR, or com­plete vi­ral sup­pres­sion, was ob­served in 10 peo­ple (45 per cent), and in 28 out of the 58 pa­tients in­fected with hep­ati­tis C alone (48 per cent).

Those with high hep­ati­tis C vi­ral loads at the start of treat­ment, with more than 400,000 in­ter­na­tional units per millil­itre of blood, were less likely to achieve RVR.

Fi­nally, 53 pa­tients were as­sessed for both RVR and for sus­tained vi­ro­log­i­cal re­sponse, or SVR, a longer-term mea­sure that is of­ten taken to mean the pa­tient has been cured. All the par­tic­i­pants who achieved RVR went on to achieve SVR, and even 59 per cent of those who did not achieve RVR went on to be cured later.

The study’s au­thors con­cluded that pa­tients treated for acute hep­ati­tis C in­fec­tion and who achieved RVR ‘‘ are highly likely to achieve SVR, ir­re­spec­tive of HIV sta­tus’’.

This is the largest study ever of an in­ject­ing drug-user pop­u­la­tion with early in­fec­tion,’’ said pro­fes­sor Dore, who is head of the vi­ral hep­ati­tis clin­i­cal re­search pro­gram at the Syd­ney-based Na­tional Cen­tre in HIV Epi­demi­ol­ogy and Clin­i­cal Re­search.

We have shown that it is fea­si­ble to treat this group, many of whom have been re­cent in­ject­ing drug users, and get re­mark­ably good out­comes.

What we are look­ing at now is to ap­ply to the NIH for an­other five years’ fund­ing, to look at the dif­fer­ent strate­gies to op­ti­mise treat­ment out­comes in this group.’’

Dore’s col­league doc­tor Gail Matthews said the high pro­por­tion of HIV-pos­i­tive cases in the study par­tic­i­pants, about onethird, prob­a­bly re­flects a cur­rent in­crease in acute HCV in this pop­u­la­tion — pre­dom­i­nantly ac­quired through sex­ual trans­mis­sion and mir­ror­ing what is be­ing re­ported from many cen­tres in Europe’’.

This has po­ten­tial im­pli­ca­tions for pub­lic health mes­sages in this group,’’ she said. Adam Cress­well’s trip to the EASL con­fer­ence in Mi­lan was or­gan­ised as part of the prize for win­ning the Pro­fes­sor Ge­off Farrell Medal, a jour­nal­ism award or­gan­ised by Hep­ati­tis Aus­tralia for writ­ing about hep­ati­tis C. Fund­ing for the award was pro­vided by the drug com­pany Scher­ing-Plough.

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