Pegasys Versus PegIntron for Combination Hepatitis C Treatment of HIV-HCV Coinfected Patients

Pegylated interferon plus ribavirin is the current standard of care for chronic hepatitis C virus (HCV) infection. Two brands of pegylated interferon are currently approved for this indication: pegylated interferon alfa-2a (Roche's Pegasys) and pegylated interferon alfa-2b (Schering-Plough's PegIntron).

At the 47th Interscience Conference on Antimicrobial Agents and Chemotherapy this week in Chicago, researchers with the Spanish GESIDA Clinical Trials Agency reported the results of a study comparing the safety and efficacy of Pegasys and PegInton, both in combination with ribavirin, in HIV-HCV coinfected patients.

The researchers conducted an analysis of participants in the GESIDA Cohort study, which prospectively follows HIV-HCV coinfected patients who started anti-HCV therapy between Jan 2000 and December 2005 at 11 institutions in Spain. The study included previously treatment-naive patients who started combination therapy with either Pegasys (n = 315) or PegIntron (n = 242) plus ribavirin.

The only significant difference in baseline characteristics was a lower proportion of patients with advanced fibrosis (stage F3-F4) in the Pegasys arm compared with the PegIntron arm (32.8% vs 42.0%). No differences were found with regard to ribavirin dose or duration of anti-HCV therapy.

The primary efficacy endpoint was a sustained virological response (SVR), defined as undetectable serum HCV RNA 24 weeks after the completion of anti-HCV therapy.

Results

• Factors independently associated with SVR by logistic regression analysis were CDC clinical HIV disease category and HCV genotype.

• Genotypes 1 or 4 were associated with a lower SVR rate than genotypes 2 or 3.

• Efficacy and safety results are summarized in the table below:

Conclusion

Based on these findings, the investigators concluded, "No differences were found in efficacy/safety between [Pegasys] and [PegIntron] for the treatment of chronic HCV infection in HIV-infected patients."

09/21//07

Reference
J Berenguer, J Gonzalez, J Lopez Aldeguer, and others. Peginterferon Alfa-2a Plus Ribavirin vs Peginterferon Alfa-2b Plus Ribavirin for Chronic Hepatitis C Virus Infection in HIV-Infected Patients. 47th Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago, September 17-20, 2007. Abstract V-1897.