title: Efficacy of and risk of bleeding during pegylated interferon plus ribavirin treatment in HIV/HCV-coinfected patients with pretreatment thrombocytopenia.
abstract: The aim of this study was to assess the efficacy of and the risk of major bleeding during pegylated interferon (peg-IFN)/ribavirin (RBV) treatment among human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients according to the pretreatment platelet count. Two hundred and seventy-four HCV/HIV-coinfected, previously naïve individuals with compensated cirrhosis enrolled in one Spanish prospective cohort who received peg-IFN/RBV were included in this study. The frequency of severe bleeding and sustained virological response (SVR) rate were compared between patients with a pretreatment platelet count ≤70,000/mm(3) and >70,000/mm(3), respectively. Sixty-one (22 %) patients had a baseline platelet count ≤70,000/mm(3). The median (Q1-Q3) pretreatment platelet count was 58,000 (49,000-65,000) cells/mm(3) in the platelet ≤70,000 group and 129,000 (102,500-166,000) cells/mm(3) in the platelet >70,000 group (p < 0.0001). Seventeen (28 %) subjects of the platelet ≤70,000 group and 71 (33 %) patients of the platelet >70,000 group achieved SVR (p = 0.4). Only 2 (3.2 %) patients in the platelet ≤70,000 group developed a severe hemorrhagic event, specifically esophageal variceal bleeding. The efficacy of therapy with peg-IFN/RBV in HIV/HCV-coinfected patients with low pretreatment platelet counts is comparable to that found in the overall subset of subjects with compensated cirrhosis. The frequency of severe hemorrhagic events related with this therapy is low in this population.
authors.affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avenida de Bellavista S/N, 41014, Sevilla, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Mira
authors.forename: K
authors.initials: K
authors.lastname: Neukam
authors.forename: L F
authors.initials: LF
authors.lastname: López-Cortés
authors.forename: A
authors.initials: A
authors.lastname: Rivero-Juárez
authors.forename: F
authors.initials: F
authors.lastname: Téllez
authors.forename: J A
authors.initials: JA
authors.lastname: Girón-González
authors.forename: I
authors.initials: I
authors.lastname: de los Santos-Gil
authors.forename: G
authors.initials: G
authors.lastname: Ojeda-Burgos
authors.forename: D
authors.initials: D
authors.lastname: Merino
authors.forename: M J
authors.initials: MJ
authors.lastname: Ríos-Villegas
authors.forename: A
authors.initials: A
authors.lastname: Collado
authors.forename: A
authors.initials: A
authors.lastname: Torres-Cornejo
authors.forename: J
authors.initials: J
authors.lastname: Macías
authors.forename: A
authors.initials: A
authors.lastname: Rivero
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Pérez
authors.forename: J A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D060085:Coinfection / Q000821:virology; D004359:Drug Therapy, Combination; D004932:Esophageal and Gastric Varices / Q000473:pathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D012306:Risk; D013030:Spain; D013921:Thrombocytopenia / Q000150:complications*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a