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Treatment of chronic hepatitis C in HIV-infected patients with interferon alpha-2b plus ribavirin

Mayte Pérez-Olmeda1, Vincent Soriano, Victor Asensi

  • 1Instituto de Salud Carlos III, Madrid 28029, Spain.

AIDS Research and Human Retroviruses
|January 8, 2004
PubMed

Insights

Treatment with ribavirin (RBV) and interferon alpha-2b (IFN-alpha) showed low sustained response rates in patients coinfected with HIV and hepatitis C virus (HCV). New therapeutic strategies are crucial for this population.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Virology

Background:

  • Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in patients with HIV.
  • Standard combination therapy for HCV may have different efficacy and safety profiles in coinfected individuals.

Purpose of the Study:

  • To evaluate the efficacy and safety of ribavirin (RBV) plus interferon alpha-2b (IFN-alpha) in HIV-infected patients with chronic HCV.
  • To compare two different dosing regimens of IFN-alpha in this coinfected population.

Main Methods:

  • A randomized trial involving 106 HIV/HCV-coinfected patients with CD4 counts >350 cells/microl.
  • Patients received RBV plus IFN-alpha at either 3 mU tiw or an induction arm (5 mU daily for 6 weeks, then 3 mU tiw) for 6 months.
  • Treatment discontinuation due to adverse events and viral load response were assessed.

Main Results:

  • Sustained virologic response (SVR) was achieved by 16% of patients in the intent-to-treat analysis.
  • HCV genotypes 2 or 3 showed a 7-fold higher response rate compared to genotypes 1 or 4.
  • Adverse events leading to discontinuation occurred in 12.3% of patients, similar to HCV-monoinfected individuals.

Conclusions:

  • Combination therapy with RBV/IFN-alpha demonstrates limited sustained response rates in HIV/HCV-coinfected patients.
  • HCV genotype significantly influences treatment outcomes.
  • Novel treatment approaches are urgently needed for effective management of HCV in this patient group.

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