title: Peginterferon-alfa mono-therapy in the treatment of acute hepatitis C in HIV-infection.
abstract: The ongoing epidemic of acute hepatitis C (AHC) infection among MSM highlights the need to identify factors allowing for optimal treatment outcome in HIV co-infected individuals. Cohort study of 105 HIV-infected patients with AHC infection from five centres in two European countries was carried out. Choice of treatment with pegIFN-alfa alone (group 1; n = 36) or pegIFN-alfa and ribavirin (RBV) (group 2; n = 69) was at the discretion of the investigator. Outcome was evaluated as RVR and SVR. Fisher's exact and Mann Whitney U tests were used for statistical analysis. All patients were male, median age was 39 years, main route of transmission MSM (91%). In 69% of patients, clinical signs of acute hepatic infection were missing, dominant HCV genotypes were 1 (64%) and 4 (16%) and mean baseline HCV-RNA was 3.559.085 IU/mL. 60% received HAART and CD4 cell count was 469/mm(3) . Overall SVR rate was 64.8% (68/105). SVR was reached in 69% of treated patients in group 1 and in 63% of treated patients in group 2 (P = 0.67) while RVR was seen in 61% and 49%, respectively (P = 0.35). Interestingly, by univariate analysis, SVR rates in group 1 were significantly higher in patients initiating therapy within 4 weeks of AHC diagnosis compared to patients initiating therapy within 5-36 weeks after diagnosis (P = 0.03). PegIFN-alfa alone or in combination with ribavirin results in similar response rates in HIV-infected patients with AHC. In particular, when treatment is initiated within 4 weeks of diagnosis, pegIFN mono-therapy might be sufficient to allow for an optimal treatment response.
authors.affiliation: Bonn University Hospital, Bonn, Germany; German Centre for Infection Research (DZIF), Partner Site Cologne-Bonn, Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Boesecke
authors.forename: S
authors.initials: S
authors.lastname: van Assen
authors.forename: H-J
authors.initials: HJ
authors.lastname: Stellbrink
authors.forename: A
authors.initials: A
authors.lastname: Baumgarten
authors.forename: P
authors.initials: P
authors.lastname: Ingiliz
authors.forename: C P
authors.initials: CP
authors.lastname: Strassburg
authors.forename: C
authors.initials: C
authors.lastname: Schwarze-Zander
authors.forename: J-C
authors.initials: JC
authors.lastname: Wasmuth
authors.forename: A I M
authors.initials: AI
authors.lastname: Hoepelman
authors.forename: J K
authors.initials: JK
authors.lastname: Rockstroh
authors.forename: J E
authors.initials: JE
authors.lastname: Arends
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005060:Europe; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a
keywords: HIV; acute hepatitis C; pegylated interferon mono-therapy