Tackling virus early best tactic
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.