The one study that bucked this trend was the
SWATCH study, also reported at ICAAC. This compared patients starting either on an efavirenz/d4T/ddI combo or on AZT/3TC/nelfinavir. A third group alternated the regimes every three months. After a year both the efavirenz and nelfinavir patients did equally well, with only 15 per cent failing. The group that swapped did even better, with no failures at all.
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A US study shows that only one in ten people co-infected with HIV and
hepatitis C get as far as being offered hep C treatment - and even then,
many refuse it. A survey of the patients at Boston University HIV clinic
show that out of 93 co-infected patients evaluated for hep C treatment,
only a third were offered therapy. Reasons for not offering it included
poor attendance, current alcohol or drug use, psychiatric illness or being
too ill to tolerate the drugs.
Even so, of the 31 actually offered hep C therapy, only nine actually
took it - the 22 others either refused it or put off the decision. "Only
10 per cent eventually agreed to start treatment," commented the
Boston team.
Even then, only a minority may actually benefit. French experts found
hepatitis C treatment only working for 10-20 per cent of co-infected patients
in 'real world' clinical situations.
A team from Georges Pompidou Hospital in Paris gave the standard
