New European HIV treatment guidelines expand treatment recommendations

Hepatitis treatment

The group writing the section on hepatitis B and C was chaired by Professor Jürgen Rockstroh of the University of Bonn. These involve new, clarified flowcharts for the initiation and management of hepatitis C treatment and also include the management of hepatitis delta (hepatitis D) in patients with hepatitis B.

The writing group of this section had a dilemma: two hepatitis C protease inhibitor drugs (boceprevir and telaprevir) are now licensed for treatment of patients with hepatitis who do not have HIV, and considerably increase the speed and efficacy of treatment, but are not licensed for patients with HIV. The printed version of the guidelines, on the basis of 12 weeks’ interim results of telaprevir in HIV/hepatitis C coinfected patients, recommends that physicians can choose to add telaprevir to standard therapy for twelve weeks. The online version may include a similar recommendation for boceprevir if positive results are received at next month’s AASLD Liver Meeting. They note that atazanavir and efavirenz are so far the only two non-NRTI drugs that have been evaluated for drug interactions with telaprevir.

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