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Hepatitis C virus and human immunodeficiency virus coinfection: where do we stand?

J E Arends1, C A B Boucher, A I M Hoepelman

  • 1Department of Internal Medicine and Infectious Diseases, Utrecht University Medical Centre, The Netherlands. j.e.arends@umcutrecht.nl

The Netherlands Journal of Medicine
|June 15, 2005
PubMed

Insights

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection impacts millions. New treatments offer improved sustained viral response (SVR) rates for coinfected patients, especially for genotypes 2 and 3.

Area of Science:

  • Virology
  • Hepatology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection is prevalent globally, particularly among intravenous drug users.
  • Antiretroviral therapy (HAART) has improved HIV survival, but HCV coinfection can accelerate liver disease progression.
  • Existing data on HCV's effect on HIV progression is conflicting.

Purpose of the Study:

  • To evaluate the efficacy of pegylated interferon plus ribavirin in treating HCV/HIV coinfected patients.
  • To compare sustained viral response (SVR) rates across different HCV genotypes in coinfected individuals.
  • To assess treatment duration and side effect profiles in this population.

Main Methods:

  • Analysis of four randomized controlled trials.
  • Intention-to-treat analysis of sustained viral response (SVR) rates.
  • Stratification of results by HCV genotype (1, 2, 3, and 4).

Main Results:

  • Overall SVR rates ranged from 27% to 44%.
  • SVR rates were lower for genotype 1 (14-38%) compared to genotypes 2 and 3 (53-73%).
  • Treatment duration for genotypes 2 and 3 was 48 weeks, longer than for monoinfected patients.

Conclusions:

  • Pegylated interferon plus ribavirin offers a significantly improved treatment option for HCV/HIV coinfected patients compared to conventional interferon.
  • SVR rates, while lower than in HCV-monoinfected patients, are substantial, particularly for genotypes 2 and 3.
  • The manageable side effect profile makes this combination therapy a viable option for coinfected individuals.

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