Cindy Zahnd reported on data modeled from the Swiss HIV and hepatitis C Cohort. Specifically the considered the impact of deferring treatment initiation in HIV-HCV co-infected patients. There was not difference starting in a month or 12 months. But treatment outcomes were heavily impacted by fibrosis score at treatment commencement. Delaying till F3 doubled the risk of disease progression and delaying till F4 saw a five fold increase.
Interestingly patients with F4 were more likely to have a serious or fatal liver event even after having had an SVR on treatment. This is probably because even though the virus was cleared irreversible damage was sustained. A salient message for clinicians and patients who might be waiting for the next best drug to come along.
You can view this and other coinfection oral presentations from the http://www.croiwebcasts.org/ it was session O-12 Curing hepatitis C: Mission accomplished