Therapeutic Strategies for the Management of HCV/HIV co- infection

最近在治疗和监测艾滋病毒-1感染方面取得的进展大大减少了与艾滋病毒有关的疾病和死亡率；然而，对艾滋病毒感染者的管理已变得越来越复杂。我们正在进行的研究包括：(1)确定丙型肝炎病毒对基于聚乙二醇化干扰素的治疗的反应；(2)评估在管理艾滋病毒感染人群中丙型肝炎病毒的新治疗策略；(3)开发预测丙型肝炎病毒对现有和新疗法的反应的新的基因组和蛋白质组标记。对丙型肝炎/HIV混合感染者标准丙型肝炎治疗的病毒反应的动力学分析表明，根据丙型肝炎病毒治疗后血浆中病毒水平的初始反应，预测丙型肝炎治疗的长期反应是可能的。在这些受试者中使用聚乙二醇化干扰素和利巴韦林的联合治疗，我们正在确定基因组和蛋白质标记是否可以在治疗开始前预测治疗的反应。随后的临床试验将确定更频繁剂量的聚乙二醇化干扰素与利巴韦林联合使用是否会增强丙型肝炎和艾滋病毒混合感染者对丙型肝炎治疗的病毒动力学反应。一项使用白蛋白结合干扰素α(Alb-Interferon)治疗艾滋病毒感染患者丙型肝炎的新临床试验将于今年晚些时候开始登记。

Recent advances in the treatment and monitoring of HIV-1 infection have substantially diminished HIV-associated illness and mortality; however the management of HIV-infected patients has become increasingly complex. We are conducting studies that: (1) define the Hepatitis C viral response to pegylated interferon-based therapy in HIV co-infected individuals (2) evaluate novel therapeutic strategies in the management of Hepatitis C virus in HIV co-infected individuals, and (3) develop novel genomic and proteomic markers that predict Hepatitis C viral response to existing and novel therapies. Analyses of the kinetics of the viral response to standard Hepatitis C therapy in Hepatitis C/HIV co-infected individuals suggest that it may be possible to predict a long term response to anti-Hepatitis C therapy based on the initial response to therapy of Hepatitis C virus levels in plasma. Using combination therapy of pegylated interferon together with ribavirin in these subjects, we are determining whether genomic and proteomic markers can predict response to therapy prior to initiation of treatment. Subsequent clinical trials will determine whether more frequent doses of pegylated interferon in combination with ribavirin enhance the viral kinetic response to Hepatitis C therapy in persons co-infected with Hepatitis C and HIV. A new clinical trial using albumin-conjugated interferon alpha (Alb-Interferon) to treat Hepatitis C in HIV-infected patients will begin enrollment later this year.