[42] PEGYLATED INTERFERON PLUS RIBAVIRIN FOR THE TREATMENT OF CHRONIC HEPATITIS C IN HIV-INFECTED PATIENTS

1st International AIDS Society Conference on HIV Pathogenesis and Treatment

Buenos Aires, Argentina - July 8-11, 2001

[TITLE:] PEGYLATED INTERFERON PLUS RIBAVIRIN FOR THE TREATMENT OF CHRONIC HEPATITIS C IN HIV-INFECTED PATIENTS

[AUTHOR(S):] Soriano, V; García-Samaniego, J; Pérez-Olmeda, M; Barreiro, P; Núnez, M; Rodríguez-Rosado, R; Jiménez-Nácher, I
Instituto De Salud Carlos III, Madrid, Spain

IAS Conf HIV Pathog Treat 2001 Jul 8-11;1st: Abstract No. 42

[ABSTRACT:] 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.

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