8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV San Francisco, California - September 24 - 26, 2006

BODY COMPOSITION CHANGES DURING PEGINTERFERON A PLUS RIBAVIRIN COMBINED THERAPY IN HCV-HIV COINFECTED PATIENTS

Antiviral Therapy 2006; 11:L19 (abstract no. 25)

A Milinkovic, M Laguno, E de Lazzari, J Murillas, JL Blanco, A Leon, M Larrousse, E Martinez, M Lonca, S Vidal, JM Gatell and J Mallolas
Hospital Clínic, Barcelona, Spain

BACKGROUND: Current standard of care for treatment of chronic HCV in HIV-coinfected patients is combination therapy with peginterferon α (peg-IFN) and ribavirin (RBV). It has been described that this treatment may lead to weight loss and clinical worsening of peripheral lipoatrophy, although the magnitude of this loss or reversal of this changes are not known.

METHODS: Sub analysis of available data from a randomized, open-label, single-centre clinical trial including HIV patients on thymidine analogue- and ddI-sparing antiretroviral therapy, with chronic hepatitis C that were assigned to: peg-IFN-α2b (100–1.5 µg/kg/week) or peg-IFN-α2a (180 µg/week) plus RBV (800–1200 mg/day) therapy. Duration of treatment was 48 weeks (only 24 weeks in a case of lack of virological response). Weight, body composition (measured by DEXA) and fasting metabolic parameters were assessed at baseline, at the end of the therapy and 24 weeks after HCV treatment was stopped.

RESULTS: Twenty-four (71% men) patients were recruited for the study (13 in peg-IFN-α2b and 11 in peg-IFN-α2a arm). At baseline one quarter of patients included had clinical evidence of moderate or severe lipoatrophy, and median values of metabolic parameters were within normal range. During HCV therapy total body weight decreased significantly (median: -2.2 kg; IQR: -4.5; -0.5; P=0.0047. Total fat (median: -2.1 kg; IQR: -4.2; -0.9; P=0.0062), predominantly peripheral fat was body compartment mostly affected. Although the therapy with peg-IFN-α2b was associated with a trend toward a higher decrease in body fat, the only statistically significant change among interferon groups was observed in lost of arm fat (P=0.035). Body weight and total fat reverted to their baseline values 6 month after cessation of therapy. Total lean mass and bone mineral density remained stable and no significant changes were observed in any of metabolic parameters during the study.

CONCLUSION: The HCV therapy leads to weight loss and decrease of peripheral fat, but these changes seems to be reversible to pre-treatment values after cessation of therapy. The type of peginterferon used could be related with greater transitory changes in weight and fat.

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2006-09-24
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