AIDS / HIV & HEPATITIS C INFECTION: RECENT TREATMENT MODULE OF TREATING HIV AND HEPATITIS TOGETHER WITH SOFOSBUVIR

PROF.DRRAM ,HIV/AIDS,SEX DIS.,SEX WEAK.& ABORTION SPECIALIST
profdrram@gmail.com,+917838059592,+919832025033,DELHI –NCR,IND
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Hepatitic C is a silent infection like HIv and is common with many patients of hHiv particualrly those are IV DRUG USER OR BLOOD CONTAMINATED.WITH HEPATITIS C HIV MUST BE TREATED FIRST AS START ANTI HIV TREATMENT OR ARV MEDICINES FIRST KEEP VIRAL LOAD OF HIV LOW AND CD4 COUNT MORE FOR BETTER RESULTFOR HCV CURE.
Hepatitis c produce cirrhosis of liver and liver cancer if not treated,we decide to treat it when we see that Liver function of patient deteriorates,Features of cirrhosis like Pedal Oedema,Black spots,Dilated abdominal Veins,Piles or oesophageal varices with Ascites or fluid in abdome with splenomegaly starts and cirrhosis confirmed by either Biopsy or Fibroscan or Usg or we see features of cancer then we resect this liver and transplant new one and with it we treat hepatitis c too.
so,if liver enzymes alters or fetures of cirrhosis starts of if HCV viral load IU/ML OR COPIES/ML(1IU/ML=7COPIES/ML) seen in good concentration and patient opt for therapy as if treatment taken completed than unlike HIV,HCV is curable after 12-24 wks now with sobosfuvir and previously 48 wks without sofosbuvir SVR (SUSTAINED VIRAL RESPONSE) OR VIRAL LOAD ZERO OF HCV IS POSSIBLE
we see that what type of HCV it is as Genotype 1 or 1A or 1B or type 2,Type 3 or type 4 .Genotype HCV 1A and type 4 are hard to treat they need peglyated Interferon with Ribvarin for 24-48 wks with Bocprevir and telaprevir either if alone or with HIV but with Sofosbuvir now it is found that interferon-free regimen of sofosbuvir plus ribavirin for 24 weeks led to sustained response in three-quarters of previously untreated people with genotype 1 hepatitis C and HIV co-infection in the PHOTON-1 study,and 12 wks therapy for type 2 but for type 3 also a course of 24 wks needed like type 1A not shorter 12 wks as for type 2 as we think type 2 and type 3 are easy responders.according to a report at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this week in Boston.

People with HIV/HCV co-infection experience more rapid liver disease progression and do not respond as well to interferon-based therapy as people with hepatitis C alone. Direct-acting antivirals like sofosfuvir or SOVALIDI or PREVIOUS KNOWN GS-7977 that target different steps of the HCV lifecycle offer the prospect of shorter treatment, fewer side-effects and higher cure rates for both HCV mono-infected and HIV/HCV co-infected patients.In less advanced case or type 2 or type 3 simprenavir can also be tried.Previous to this costly Sofosbuvir (ruprees 50000 dollars for one month )but pegylated Interferon is very toxic and cannot be easily tolerated by every pateient previously we were using INTERFERON ALPHA 2a OR ALPHA 2b which dose was twice a week but now pegylated once a week injection,Ribarin in dose 0f 1000-1200 mg as per body weight and Sofosbuvir 400 mg once a day only.