An inability to process sugars properly is associated with faster liver damage in people who are co-infected with HIV and hepatitis C.

Canadian researchers found that insulin resistance was a big risk factor for the progression of fibrosis (hardening) of the liver.

They already knew that infection with hepatitis C was linked with insulin resistance. Furthermore, insulin resistance can mean that treatment for hepatitis C doesn’t work properly.

Researchers therefore wanted to see if an inability to process sugars led to more rapid liver fibrosis in people with HIV and hepatitis C.

Their research involved 158 people, 55% of whom were diagnosed with insulin resistance when they entered the study.

The participants were monitored for approximately 18 months. During this time 18% developed liver fibrosis.

People who had insulin resistance when they joined the study were almost twice as likely to develop fibrosis than people who were able to process sugars.

The researchers think that the inflammation caused by hepatitis C could be an explanation for increased insulin resistance.

For more information on HIV and hepatitis co-infection, you can read or download our HIV & hepatitis booklet from www.aidsmap.com/booklets.

People with HIV and hepatitis co-infection who are taking the anti-hepatitis C drug ribavirin can safely take an antiretroviral combination that includes abacavir (Ziagen, also in Trizivir and Kivexa), new research shows.

Some – but not all – earlier research had shown poorer treatment outcomes in people with co-infection taking hepatitis C treatment who were also being treated with abacavir.

It had been suggested that this could be due to an interaction between ribavirin and abacavir.

But new French research shows this isn’t the case.

It looked at responses to hepatitis C treatment in 124 people with HIV and hepatitis C co-infection. Hepatitis C therapy consisted of pegylated interferon and weight-based ribavirin.

They compared responses to this treatment according to whether people were taking abacavir.

Almost all the study participants (95%) were taking HIV treatment and 22% were taking a combination that contained abacavir.

Response rates to treatment after four and twelve weeks (early markers of the likely success of therapy) did not differ between those who were taking abacavir and those who were not.

A sustained virological response (undetectable hepatitis C viral load 24 weeks after completing treatment, considered a cure) was seen in 45% of people treated with abacavir, compared to a rate of 24% in people taking a combination that did not contain abacavir.

Response rates were comparable between people treated with abacavir and those taking a combination that included tenofovir (Viread, also in Truvada, Eviplera and Atripla).

The researchers therefore conclude that HIV treatment that includes abacavir is a safe option for people taking hepatitis C therapy.

For more information on drug interactions, visit our topics page on drug interactions and pharmacokinetics. For detailed information on individual drug interactions, the University of Liverpool maintains a useful website at www.hiv-druginteractions.org.

Co-infection with GB virus C (GBV-C, sometimes called hepatitis G) reduces the risk of death for people who are seriously ill because of HIV.

GBV-C is a non-dangerous infection that is transmitted in similar ways to HIV.

There’s been a lot of debate about its impact on HIV disease progression. Some research showed that it had significant benefits, but not all doctors have been convinced.

To get a clearer idea of its effects, US doctors analysed blood samples obtained from HIV-positive people in 1996-97. All had a very low CD4 cell count.

They looked at the prevalence of GBV-C infection at the start of the study and also checked samples to see how many people became infected with the virus during the study.

The participants were monitored for a little over eight months. Because they were so ill, over half died.

Co-infection with GBV-C improved the chances of survival by up to 78%. This was the case even after taking into account traditional factors associated with prognosis such as CD4 cell count and viral load.

A doctor who wrote an editorial in the journal which published the study believes that these results settle any debate about the benefits of GBV-C co-infection. He believes that GBV-C vaccination could help reduce HIV-related mortality in poorer countries where there is limited access to HIV treatment.