title: Successful treatment of acute hepatitis C virus in HIV positive patients using the European AIDS Treatment Network guidelines for treatment duration.
abstract: BACKGROUND
  The incidence of acute hepatitis C virus (HCV) in HIV-positive patients is rising. Recent studies summarized by the European AIDS Treatment Network (NEAT)(1) show that pegylated interferon alpha (PEG-IFNα) and ribavirin can lead to a sustained virological response (SVR) in approximately 60-80% of patients. Controversy remains on when to start treatment and whether 24 or 48 weeks of treatment lead to better outcomes.
  
  
  OBJECTIVE
  To assess the effectiveness of a treatment strategy for acute HCV infection in HIV-positive patients, in which patients with undetectable HCV RNA at 4 weeks (rapid virological response, RVR) receive 24 weeks, while those without receive 48 weeks of PEG-IFNα and ribavirin, as per the NEAT guidelines.
  
  
  METHODS
  A retrospective cohort study of HIV-positive patients diagnosed with acute HCV infection between December 2006 and May 2010. Those who received acute treatment with PEG-IFNα and ribavirin had HCV RNA levels monitored and outcomes evaluated. For patients who did not receive acute treatment, the reason for deferral and most recent available HCV RNA were recorded.
  
  
  RESULTS
  Twenty-two patients received acute treatment with PEG-IFNα and ribavirin. Twelve patients achieved RVR and had 24 weeks treatment, 10 patients had no RVR and had 48 weeks treatment. Two patients discontinued treatment (due to adverse effects [AEs] and failure to suppress HCV RNA sufficiently at 12 weeks). All 20 patients who completed treatment had SVR.
  
  
  CONCLUSIONS
  Our high SVR rate of 91% supports the new NEAT treatment duration recommendations.
authors.affiliation: The Grahame Hayton Unit, Barts and the London NHS Trust, Royal London Hospital, Whitechapel, London E1 1BB, United Kingdom.
authors.forename: Jienchi
authors.initials: J
authors.lastname: Dorward
authors.forename: Nigel
authors.initials: N
authors.lastname: Garrett
authors.forename: Duncan
authors.initials: D
authors.lastname: Scott
authors.forename: Matthew
authors.initials: M
authors.lastname: Buckland
authors.forename: Chloe
authors.initials: C
authors.lastname: Orkin
authors.forename: Guy
authors.initials: G
authors.lastname: Baily
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin