Gilleece Y, Nelson M, Asboe D, Browne R, Atkins M, Gazzard BG; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. MoPeB3296.
Chelsea & Westminster Hospital, London, United Kingdom
Methods: Prospective evaluation of acute HCV infection between January 1997 and October 2003. Results: 50 individuals were identified, 44 in the last 18 months. All were male homosexuals, mean age 37yrs. 40 were identified via newly abnormal liver function tests, 3 from sexual contact with HCV partner, 4 from jaundice, 2 were screened at HIV seroconversion and 1 had history of recent ivdu. 15 were diagnosed with syphilis in year prior to HCV seroconversion. All were offered therapy. 23 individuals declined treatment, 13 of whom spontaneously converted to PCR-ve. Individuals who spontaneously converted to PCR-ve were more likely to have CD4 count >500 (62% vs 20%) and had higher ALT at diagnosis. Of 27 individuals who received therapy, 22 finished treatment, 5 are continuing. One received interferon/ribavirin, one pegylated interferon alone, the rest pegylated interferon/ribavirin although, 2 individuals developed anaemia requiring discontinuation of ribavirin. 14/22 individuals have been successfully treated to PCR negativity with follow-up between 1-11 months. 3/5 individuals presently receiving treatment have poor antiviral response. 8 individuals failed treatment, one due to toxicity, 7 lack of response. Mean CD4 count loss on treatment was 5.4 cells/week. CD4 percentage unchanged. 6/11 (55%) of those with a detectable HIV VL had >0.5 log drop of HIV VL on treatment. Major toxicities were depression (14), neutropaenia<1.0 (15) and flu-like symptoms (8). Conclusion In recent months we have seen an epidemic of acute hepatitis C, probably sexually transmitted with individuals reporting unsafe sex and higher rate of recent syphilis infection. Treatment of acute hepatitis C resulted in clearance of hepatitis C in 14/22 (66%) who completed therapy. A high percentage of individuals seroconvert spontaneously. Treatment response to interferon is lower than in HIV negative population. Treatment is associated with immunological deterioration as regards CD4 cell count but not percentage. Anti HIV response to treatment was poor.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Alanine Transaminase
- CD4 Lymphocyte Count
- Central Nervous System Viral Diseases
- Communicable Diseases
- Drug Therapy, Combination
- HIV Infections
- HIV Seropositivity
- Hepacivirus
- Hepatitis C
- Homosexuality, Male
- Incidence
- Interferon Alfa-2b
- Interferons
- Longitudinal Studies
- Male
- Ribavirin
- drug therapy
- epidemiology
- therapy
Other ID:
UI: 102279598
From Meeting Abstracts