Treatment Update from Seattle: Part two

There was little at the Seattle

Conference that was totally new on hepatitis C (HCV), apart from an interesting talk by Stuart Ray, Assistant Professor of Medicine at Johns Hopkins University, that compared the hep C problem to the HIV one.
About 40 million people worldwide have HIV, Ray said, whereas the estimate for the number infected by HCV varies from 40 million to 175 million - Francesca Torriani of the University of California, San Diego thought the upper figure more likely. About one million are co-infected with both viruses.

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In the US, about one million have HIV and about four million have HCV. The US death rates due to each virus are already comparable - about 15,000 a year due to HIV and staying stable, about 10,000 a year due to HCV and increasing.
HIV co-infection doubles both the death rate and the rate of progression to cirrhosis (liver damage).
So far, so gloomy for the co-infected. But treatment success rates with the state-of-the-art pegylated interferon-plus-ribavirin combo therapy continue to creep up slowly. In Ray Chung's group, 38 per cent of people treated achieved an early 'sustained viral response', ie had no detectable HCV in their systems a year later. The Massachusetts group have a high level of the nastier genotype one (G1) variety of HCV, which is much more resistant to the therapy - only a quarter of his G1 patients responded.

In contrast, a European group cited by Chung did much better. An average of