Review of 2nd International Workshop on HIV and Hepatitis Co-infection

Key issues debated at the Second International Workshop on HIV and Hepatitis Co-infection, held in Amsterdam, the Netherlands, last month included: the importance of treating hepatitis co-infection; the pros and cons of highly-active antiretroviral therapy (HAART) in HCV/ HIV co-infected patients; the timing of anti-HCV therapy; the optimization of response rates and the treatment of non-responders. Details of ENDURE, a newly-announced maintenance trial to evaluate the safety and efficacy of low-dose peginterferon alfa-2b (PegIntron, Schering-Plough) in treating chronic HCV infection in HCV/HIV co-infected patients unresponsive to previous combination treatment with peginterferon + ribavirin (RBV), were also discussed.

The use of highly active antiretroviral therapy (HAART) in patients with hepatitis co-infection remains controversial. Jurgen Rockstroh, Department of Medicine, University of Bonn, reviewed the benefits of HAART and Marina Nunez of the Hospital Carlos III, Madrid, Spain, outlined its disadvantages.

Dr Rockstroh reviewed the results of studies showing that HIV patients with hepatitis co-infections are much more likely to have cirrhosis and/or die from liver disease than those with HIV alone or those with a stable CD4 cell count. He suggested that there could be a threshold CD4 cell count required for a beneficial impact on liver disease and added that predictors for liver related mortality include no HAART, low CD4 cell count and increased age.