13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

THE MANAGEMENT AND TREATMENT OF ACUTE HEPATITIS C IN HIV-INFECTED INDIVIDUALS

HIV Med 2007; 8(Suppl. 1):2 (abstract no. O8)

Emma Low, Alex Azwa, Christopher Scott, Mark Atkins, Michael Anderson and Mark Nelson
Chelsea and Westminster Hospital, London, UK

OBJECTIVES: To evaluate the efficacy of 24 weeks of PEG-INF (pegylated interferon) plus weight-based ribavirin in the treatment of acute hepatitis C (AHC) in HIV co-infected individuals and to identify factors associated with treatment success.

METHODS: All patients diagnosed with AHC/HIV co-infection in our unit are entered into a prospective database. We conducted an analysis of this data. The primary endpoint was a sustained virological response (SVR – HCV RNA undetectable at 24 weeks after therapy).

RESULTS: A total of 110 HIV-positive MSM have been diagnosed with AHC. 17.4% spontaneously cleared the virus, 75% by 12 weeks. Factors associated with spontaneous seroconversion were a lower HCV viral load (6741 versus 1,329,454 copies/mL, P<0.001), a higher CD4 cell count (564 versus 413, P<0.011) and a non 1 genotype (P<0.001). 73 patients accepted treatment. Of those treated 20 have not yet reached 24 weeks post therapy (six are undetectable at week 12 and 9 awaiting week 12 data). Of the remaining 53 patients, 35 (66%) achieved a SVR. 18 failed therapy; 10 virological failure, six toxicity and two non-compliance. Treatment success was significantly associated with a higher median CD4% at the start of therapy (29% versus 24.1%, P<0.007), but not genotype P=0.908).

CONCLUSIONS: Treating AHC with 24 weeks of PEG-INF plus ribavirin achieves higher treatment success rates than treating chronic hepatitis C in co-infected patients. Success rates do not match those of HIV-uninfected individuals.

2007-03-29
O8

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