This article first appeared in POZ magazine here.
As hepatitis C treatment undergoes a revolution akin to the introduction of HIV antiretrovirals, the doors are swinging wide open for people coinfected with HIV to be cured of hep C.
If you think that having HIV means you can’t be cured of a coinfection with hepatitis C, then think again. If you think the only way to rid yourself of the hepatitis C virus (HCV) and to spare your liver of its damaging consequences is to undergo a year of interferon treatment, suffering from the drug’s miserable flu-like side effects, there is good news for you.
The hep C revolution is upon us. Echoing the 1996 introduction of HIV antiretroviral cocktails, 2014 is all but certain to go down in history as HCV’s watershed year (give or take a few months on either end). Two highly tolerable new drugs, Gilead Sciences’ Sovaldi (sofosbuvir) and Janssen’s Olysio (simeprevir), were approved at the close of 2013, expanding current treatment options and upping the chances of a cure for both mono- and coinfected people with hep C. (“Coinfected” is shorthand for having both HIV and HCV.) More important, though, these drugs have set the stage for the likely introduction, beginning later this year or early next, of numerous combination hep C treatments that will do away with interferon for good and up cure rates to near-perfect levels.
As recently as three years ago, hep C was very difficult to treat, requiring the dreaded year of interferon, plus the drug ribavirin, which can cause anemia. The chance of actually curing the virus was low enough to call into question whether such onerous treatment was actually worth the price in personal suffering. The prospects were especially bleak for those coinfected with HIV—studies put cure rates as low as 27 percent—because HIV blunted interferon’s therapeutic effects. Cirrhosis, which is more common in those who are coinfected, also took a bite out of interferon’s efficacy.
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