Only a handful of presentations at this year’s DDW meeting covered HIV/HCV coinfection.

Most research indicates that HCV-related liver damage progresses more rapidly in HIV-positive individuals, although this appears to be less true for patients on effective HAART. Thus, it is important to understand the best method of treating hepatitis C in the coinfected population.

Researchers conducted a meta-analysis of studies comparing treatments for HCV in coinfected patients. They performed searches of the MEDLINE and Cochrane databases, as well as abstracts from national scientific meetings.

The analysis included six randomized clinical trials with a total of 1756 patients. The aggregate data revealed that:

• Sustained virological response (SVR) rates were higher for coinfected patients treated with pegylated interferon plus ribavirin, compared with conventional interferon plus ribavirin (odds ratio [OR] 3.0; 95% confidence interval [CI] 2.27-3.96; P < 0.0001).
• The superior efficacy of pegylated interferon plus ribavirin held for patients with hard-to-treat genotypes 1 and 4 (OR 4.40; CI 2.75-7.03; P < 0.0001), as well as the easier-to-treat genotypes 2 and 3 (OR 2.56; CI 1.71-3.85; P < 0.0001).
• SVR rates for pegylated interferon plus ribavirin were also higher compared with pegylated interferon monotherapy (OR 2.60; CI 1.84-3.67; P < 0.0001).
• Severe adverse effects and rates of premature withdrawal from treatment were similar with pegylated and conventional interferon.

The researchers concluded that HIV-positive patients with chronic HCV have a greater likelihood of achieving SVR with pegylated interferon plus ribavirin compared with conventional interferon plus ribavirin or pegylated interferon monotherapy, without an increased rate of serious adverse events.

6/2/06

Reference