[Efficacy of peginterferon plus ribavirin for HIV-HCV co-infection. Results of the APRICOT study].
Until the publication in 2004 of the Apricot, ACTG 5071, and ANRS Ribavic trials, data about the treatment of patients coinfected with HIV and HCV were sparse. The international Apricot study included 868 HIV-HCV-coinfected patients naive of all HCV treatments. They were randomized into 3 groups for 48 weeks of hepatitis C treatment by peginterferon alpha-2a + ribavirin, or peginterferon alpha-2a + placebo, or interferon alpha-2a + ribavirin. Six months after treatment stopped, sustained virologic response (the principal efficacy criterion, intention-to-treat analysis) was observed in 40% of patients treated by peginterferon + ribavirin (29% for the nonresponsive genotype 1, and 62% for genotypes 2 and 3), 20% of those receiving peginterferon + placebo, and 12% of those in the group of nonpegylated interferon + ribavirin. This study also validated the positive and negative predictive values of viral load analyzed at 12 weeks of treatment; it was best for patients in genotypes 2 and 3. The factors associated with the best virologic response were a non-1 genotype and a low HCV viral load (< 800,000 IU/mL). As pointed out in the guidelines of the last European consensus conference on coinfection, the combination of peginterferon + ribavirin is currently the reference treatment for chronic hepatitis C. It should also be the preferred treatment for patients with HIV-HCV coinfection.
Pialoux
G
G
Service des maladies infectieuses et tropicales, Hôpital Tenon, Paris. gilles.pialoux@tnn.aphp.fr
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D015337:Multicenter Studies as Topic; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin