European consensus meeting draws up guidelines on HIV and hepatitis
treatment
AIDSMAP NEWS
Keith Alcorn, Monday, March 07, 2005
A meeting of European and North American hepatitis and HIV specialists held
last week in Paris has announced pan-European guidelines for the management
of HIV and hepatitis.
A panel of ten specialists from eight European countries, led by Professor
Alfredo Alberti (Italy) and Professor Nathan Clumeck (Belgium), drew up the
recommendations. "Our goal is to ensure that a consistent therapeutic
approach is adopted at the European level, and to increase the number of
patients who are diagnosed and treated," said Professor Clumeck. "Today
there is too much variation from one country to another. Our recommendations
are adapted to the European context, both in terms of the patients and the
health care systems."
The First European Consensus Conference on the Treatment of Chronic
Hepatitis B and C in HIV Co-infected Patients made the following key
recommendations:
HIV/HCV: Treatment should consist of a combination of pegylated interferon
and ribavirin. The consensus meeting recommended increasing the dose of
ribavirin among patients infected with genotype 1 HCV, which is more
resistant to treatment than the other genotypes. After the first three
months of treatment, efficacy can be assessed to determine whether or not to
continue to the end of the treatment period (48 weeks).
HIV/HBV: Antiviral compounds are effective against both HIV and HBV, but
they are complex to administer because both viruses may develop resistance
to the drugs. The choice of which combinations to use must be made according
to identifiable resistance and the specific biological parameters of each
patient.
For patients whose immune system has been significantly depressed (low CD4
counts), antiretroviral treatment for HIV must first enable the CD4 count to
rise, before treatment for HCV and HBV can begin.
There is a need for further studies to better understand the natural
progression of co-infections and to determine exact treatment dosages and
durations. Data about infection with HBV and HIV/HBV co-infection is
especially lacking. One of the pressing questions that must be addressed is
whether or not to continue HBV treatment, perhaps with reduced doses, when
the viral response is not very satisfactory, in order to slow progression
toward liver disease or the worsening of hepatitis B disease.
Studies to evaluate new drugs currently under development be conducted at an
earlier stage among patients co-infected with HIV and hepatitis B and C
viruses.
These recommendations are due to be published in full in the Journal of
Hepatology in May 2005.
http://www.aidsmap.com/en/news/94C14523-5AEF-4F22-A33C-CC7E486C294B.asp
| 
发表于 2005-3-10 09:21
