AEGiS-13IAC: Good tolerance of Ribavirin + Interferon therapy given for HCV chronic hepatitis in HIV-HCV coinfected patients (pts).

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Good tolerance of Ribavirin + Interferon therapy given for HCV chronic hepatitis in HIV-HCV coinfected patients (pts).

Int Conf AIDS 2000 Jul 9-14; 13:42 (abstract no.. LbPeB7043)

Aumaitre H, Schiemann R, Branger M, Ralaimazava P, Cremieux AC, Bouchaud O
Hopital Bichat-Claude Bernard, Paris, France. Fax: +33 1 422 953 00.

BACKGROUND: IFN therapy in HCV chronic hepatitis (HCH) in HIV coinfected patients (HIV-HCV) is poorly effective. Since the combination therapy Interferon + Ribavirin (IFN-RIBA) improves the efficacy in nonHIV pts, we evaluate tolerance of IFN-RIBA for HIV-HCV.

METHODS: 32 consecutive HIV-HCV pts (8 female, 24 male), mean age 38 yrs (± 4.6) with biopsy proven HCH were included and treated with IFN induction schedule (5MU daily) given subcutaneously for 4 weeks (wk) then 3MU (3 tiw) for 44 wk and RIBA(400 mg bid) for 48 wk.

RESULTS: Mean Knodell score was 10.2 (± 2.3), 2 pts had cirrhosis; HCV serotype 1 was frequent (6/7). 23/32 (72%) were IVDU. Mean CD4 count was 482/mm³ (± 190),mean HIV viral load (VL) was 6900 Eq-copies/ml and 4 had a previous history of AIDS at enrollment. All but 4 pts were treated with HAART. Mean follow up was 23 wk (± 12 wk) until May 2000; 7 pts finished the 48-wk course of treatment. One pt stopped IFNRIBA at wk 5 because of psychiatric disorders and I because of nonrelated pancreatitis. IFN was temporary reduced in 1 pt because of thrombopenia. Weight loss occurred in all pts (mean 2.1 kg). Anemia (decrease of mean 2.2 g/dl hemoglobin) occurred in 25/30 (83%)pts but reversed at mean wk 12. Two pts experienced hypothyroidism at wk 40. A transient decrease in CD4 (mean 72.5/mm³ ± 54) occurred in all pts, during the first 4 wk of treatment and was reversible in 17/28 (61 %). No escape of HIV VL and no need to change anti-retroviral therapy (ARV)were observed. ALT response was achieved in 24/30 pt (80%). At time, HCV-RNA undetectable value was achieved in 1/7 pt (RT-PCR, sensitivity 100 Eq-copies/ml).

CONCLUSION: IFN-RIBA has few side-effects in HIV-HCV pts, even with an IFN induction schedule. No clinically significant interaction with ARV was observed. Long term tolerance must be confirmed.

Keywords: AEGIS, Ribavirin, HIV, Hepacivirus, HIV Infections, Hepatitis, Chronic, Hepatitis C, Chronic, CD4 Lymphocyte Count, Interferons, HIV Seropositivity, Substance-Related Disorders, Anti-HIV Agents, Acquired Immunodeficiency Syndrome, Female, Male, Human, AIDS
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