title: Pegylated IFN-alpha2b plus ribavirin as therapy for chronic hepatitis C in HIV-infected patients.
abstract: BACKGROUND
  Treatment of hepatitis C virus (HCV) has become a major challenge in HIV-infected individuals. No data exist on the efficacy and tolerability of pegylated IFN (peg-IFN) plus ribavirin in HIV-co-infected patients.
  
  
  METHODS
  Subcutaneous peg-IFN (150 microg weekly during the first 12 weeks and 100 microg weekly thereafter) plus ribavirin (400 mg twice a day) was given to 68 HIV-infected patients with chronic hepatitis C, having CD4 cell counts greater than 300 cells/microl, plasma HIV-RNA less than 5000 copies/ml, and elevated aminotransferase levels. All were naive for IFN, and 73% were receiving antiretroviral drugs.
  
  
  RESULTS
  Plasma HCV-RNA levels greater than 800 000 IU/ml were seen in 50%, and 35% carried HCV genotype 3. Adverse events leading to treatment discontinuation occurred in 10 patients (15%). One patient taking didanosine developed pancreatitis. Severe weight loss occurred in 70% of patients. Clearance of HCV-RNA at the end of therapy (6 months for HCV-3 and 12 months for HCV-1/4) occurred in 50% of patients (81% with HCV-3 versus 30% with HCV-1/4). As 30% relapsed, the overall sustained response rate was 35% (28% in the intent-to-treat analysis). The main predictors of response were infection with HCV-3 and low HCV load.
  
  
  CONCLUSIONS
  Treatment with peg-IFN and ribavirin is relatively well-tolerated in HIV/HCV-co-infected patients, although new side-effects, including pancreatitis and severe weight loss, may result from the interaction of ribavirin with antiretroviral drugs. Overall, therapy provides cure to one third of patients, a rate significantly lower than that seen in HCV-monoinfected individuals. Given that relapses are common, extended periods of therapy should be investigated.
authors.affiliation: Service of Infectious Diseases and bHepatology Unit, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Mayte
authors.initials: M
authors.lastname: Pérez-Olmeda
authors.forename: Marina
authors.initials: M
authors.lastname: Núñez
authors.forename: Miriam
authors.initials: M
authors.lastname: Romero
authors.forename: Juan
authors.initials: J
authors.lastname: González
authors.forename: Angeles
authors.initials: A
authors.lastname: Castro
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Arribas
authors.forename: José
authors.initials: J
authors.lastname: Pedreira
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
authors.forename: Javier
authors.initials: J
authors.lastname: García-Samaniego
authors.forename: Luz
authors.initials: L
authors.lastname: Martín-Carbonero
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Jiménez-Nácher
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*; D019562:Viral Load
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin