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Peginterferon Alfa-2a plus ribavirin versus interferon alfa-2a plus ribavirin for chronic hepatitis C in
Raymond T Chung1, Janet Andersen, Paul Volberding
1Massachusetts General Hospital, Boston, MA 02114, USA. rtchung@partners.org
The New England Journal of Medicine
|July 30, 2004
Summary
Peginterferon plus ribavirin significantly improved sustained virologic response in HIV-positive patients with chronic hepatitis C compared to interferon plus ribavirin. Strategies are needed to enhance outcomes for HCV genotype 1.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Chronic hepatitis C virus (HCV) infection complicates human immunodeficiency virus (HIV) infection.
- Treatment of HCV in coinfected individuals often results in poor tolerance and low response rates.
Purpose of the Study:
- To compare the efficacy of peginterferon plus ribavirin versus interferon plus ribavirin for treating chronic hepatitis C in HIV-coinfected patients.
Main Methods:
- A multicenter, randomized trial involving 133 HIV-HCV coinfected subjects.
- Peginterferon alfa-2a (180 microg weekly) or interferon alfa-2a (6 million IU thrice weekly for 12 weeks, then 3 million IU thrice weekly for 36 weeks) plus ribavirin.
- Assessment of virologic and histologic responses at week 24 and 24 weeks post-therapy.
Main Results:
- Peginterferon plus ribavirin yielded a significantly higher sustained virologic response rate (27% vs. 12%, P=0.03).
- Sustained virologic response was notably lower for HCV genotype 1 (14%) compared to other genotypes (73%) in the peginterferon group.
- Histologic improvement occurred in 35% of non-responders.
Conclusions:
- Peginterferon plus ribavirin is superior to interferon plus ribavirin for treating chronic hepatitis C in HIV-coinfected individuals.
- Therapeutic benefit may occur even without complete virologic clearance.
- Improved treatment strategies are essential for HCV genotype 1 in this population.
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