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

TREATMENT OF ACUTE HCV WITH 48 WEEKS OF RIBAVIRIN AND PEGYLATED INTERFERON (pIFN) IN A COHORT OF HIV CO-INFECTED PATIENTS

HIV Med 2007; 8(Suppl. 1):3 (abstract no. O9)

Alison Rodger, THN Wong, Tom Fernandez, Margaret Johnson, Gabrielle Slapak and Sanjay Bhagani
Royal Free Hospital, London, UK

AIM: An epidemic of acute hepatitis C virus (HCV) has been reported amongst HIV-positive men, due primarily to sexual transmission. The efficacy of treatment and optimal duration of anti-HCV treatment in acute HCV has not yet been established. We report the Sustained Virological Response (SVR) to 48 weeks of pIFN and ribavirin in a single-centre cohort.

METHODS: We report on 45 HIV-infected men with acute HCV infection (documented seroconversion to anti-HCV and RNA positivity) treated with pIFN (2a 180 mg/week, 2b 1.5 mg/kg/week) and ribavirin (800–1200 mg/day). SVR was defined by a negative HCV RNA (<12 IU/l) 24 weeks after treatment ended.

RESULTS: Mean age was 37 (SD ± 6.5) years. Commonest reason for test was abnormal LFTs (n=30, 60%), with a median ALT of 196 (IQ range 76–220). Most (93%) were asymptomatic on diagnosis. Median time from diagnosis to treatment was 138 days (IQ range 84–183). Genotype 1 predominated (n=30, 66%). Median HCV RNA at start treatment was 1 million IU/l. Average CD4 count was 626 (SD ± 243). 75% tolerated 48 weeks’ treatment. Twenty-six have to date completed 48 weeks’ treatment, of these 89% (n=23/26) had virological response at end treatment. SVR data is currently available on 21 patients with >24 weeks’ follow-up. In this group 76% (95% CI: 59%–93%) have a SVR. In those with genotype 1 SVR was 82% (95% Cl: 60–99%).

CONCLUSION: A total of 48 weeks of pIFN and ribavirin was tolerated by the majority of individuals in our study. HCV VL at 12 weeks predicted SVR. The overall SVR of 75 and 82% in genotype 1 patients in this study appears more favourable than published data in chronic HCV/HIV co-infection. Optimal length of treatment needs to be clarified. Clinicians need to be aware of acute HCV and the need for early treatment.

2007-03-29
O9

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