title: Treatment of chronic hepatitis C in HIV-infected patients with interferon alpha-2b plus ribavirin.
abstract: One hundred six HIV-infected patients with chronic hepatitis C virus (HCV) infection were randomized to receive ribavirin (RBV) 400 mg bid plus interferon alpha-2b (IFN-alpha) at two different doses, 3 mU tiw (control arm) or 5 mU daily for the first 6 weeks, followed by 3 mU tiw until completing 6 months of therapy (induction arm). All patients had CD4 counts above 350 cells/microl and 89% were taking antiretroviral therapy. Adverse effects leading to treatment discontinuation occurred in 12.3% of patients, a rate quite similar to that seen in HCV-monoinfected patients. Negative serum HCV-RNA values (< 60 IU/ml) were recorded in 24.7% and 35.5% of patients at 3 and 6 months of therapy. However, in the intent-to-treat analysis, sustained response was reached by only 16% of patients (22.4% in the on-treatment analysis). No differences between treatment arms were noticed. Patients with HCV genotypes 2 or 3 had a 7-fold higher response rate than those with HCV genotypes 1 or 4. Therefore, early, end-of-treatment, and sustained response rates are lower in HIV/HCV-coinfected patients treated with RBV/IFN-alpha combination therapy. Since HCV-related liver disease is currently one of the leading causes of morbidity and mortality among HIV-infected patients, new treatment options are urgently needed for coinfected individuals.
authors.affiliation: Instituto de Salud Carlos III, Madrid 28029, Spain.
authors.forename: Mayte
authors.initials: M
authors.lastname: Pérez-Olmeda
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Victor
authors.initials: V
authors.lastname: Asensi
authors.forename: Dolores
authors.initials: D
authors.lastname: Morales
authors.forename: Miriam
authors.initials: M
authors.lastname: Romero
authors.forename: Anna
authors.initials: A
authors.lastname: Ochoa
authors.forename: Fausto
authors.initials: F
authors.lastname: Sánchez-Montero
authors.forename: Miguel
authors.initials: M
authors.lastname: Santin
authors.forename: Josep
authors.initials: J
authors.lastname: Guardiola
authors.forename: Jesús
authors.initials: J
authors.lastname: Blanch
authors.forename: Marina
authors.initials: M
authors.lastname: Núñez
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Jiménez-Nácher
authors.forename: Javier
authors.initials: J
authors.lastname: García-Samaniego
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin