Ask Your Questions About-HCV! of our Hepatitis Experts:

HIV & HCV

Dear Dr. Chung:

My partner is coinfected with HIV and HCV. HIV viral load is 19,700. HCV load is over 1 million. Tcell count is 184. His doctor has prescribed a regime of 2 combivir, 1 bactrum, and 3 Sustiva per day. I was wondering how this may affect the liver and the HCV viral load? Would taking interferon and ribavirin work better? We are somewhat confused on this issue.

Thank you,

--E.

answer from Dr Chung:

It is difficult to say. However, we feel it is very important to know how much liver damage has already occurred as a result of HCV, and this can influence the aggressiveness with which the HCV should be treated. Whether it is or not, your liver tests will have to be watched carefully on the anti-HIV drugs. RC

answer from Jules Levin:

As Dr Chung says, the stage of fibrosis & liver disease is important in deciding when to begin HCV therapy. You ought to consider discussing getting a liver biopsy with your doctor, as that is the best way to assess your liver disease stage. Many HCV/HIV coinfected patients can have normal ALT (liver function tests) but moderate or advanced liver disease. In such a case HCV therapy is appropriate. In your case the cd4s are 184 and it would likely be very helpful to increase your cd4s as much as possible before starting HCV therapy. Study results suggest response to HCV therapy is better when cd4s are above 200 and likely better the higher the cd4s are. JL