|
|
Abstract
PEGYLATED INTERFERON PLUS RIBAVIRIN FOR THE TREATMENT OF CHRONIC HEPATITIS C IN HIV-INFECTED PATIENTS
SORIANO V, GARCÍA-SAMANIEGO J, PÉREZ-OLMEDA M, BARREIRO P, NÚNEZ M, RODRÍGUEZ-ROSADO R, JIMÉNEZ-NÁCHER I
Treatment of chronic hepatitis C (CHC) in HIV+ persons has become a major issue since the prognosis of HIV disease has improved dramatically and an increasing number of HCV-HIV coinfected persons develops cirrhosis and death from end-stage liver disease. Preliminary data from studies in HIV-neg individuals suggest that sustained response can be achieved in ~40% of patients with CHC using either IFN plus RBV or Pegylated-IFN (long-term release form) alone. Response rates might be even better combining Peg-IFN and RBV.
We have examined the safety and efficacy of Peg-IFN plus RBV in a group of 31 HIV+ subjects with CHC. All were naïve for IFN, but many were receiving antiretroviral drugs other than AZT. All had CD4 counts >300 and plasma HIV-RNA <5000 cop/ml when they began HCV therapy. Peg-IFN (Schering-Plough) 150 micg sc once weekly plus RBV 400 mg orally bid were prescribed in an open fashion.
At baseline all subjects had ALT/AST >1.5 the upper normal values. HCV-RNA was >800,000 IU/ml in 60%. Genotypes were HCV-1A (n=11), HCV-3 (n=10), HCV-1b (n=4) and HCV-4 (n=3).
Three months after beginning therapy, only 3 (9.7%) individuals stopped treatment due to adverse effects (fever and malaise, hypersensitivity, and lactic acidemia syndrome, respectively). Minor side effects (depression, myalgias, flu) were seen in up to 75% of patients. RBV dosing was reduced in 2 subjects and was stopped in one with lactic acidemia. No other unexpected side effects were recorded. Serum HCV-RNA become undetectable in 75% and ALT/AST normalized in 85%. In respect to HIV infection, no significant CD4+ drops nor increases in HIV-RNA were recorded. Moreover, 2 subjects showed a reduction in plasma HIV-RNA from >1000 to <50 cop/ml, most likely reflecting the antiretroviral activity of IFN.
Conclusion: The combination of Peg-IFN and RBV is relatively well-tolerated and provides a high rate of virological and biochemical response in the short-term in HIV+ subjects with CHC.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
42
Suggested Citation
"SORIANOV, et al.
PEGYLATED INTERFERON PLUS RIBAVIRIN FOR THE TREATMENT OF CHRONIC HEPATITIS C IN HIV-INFECTED PATIENTS.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
42"
|
|
|