ICAAC 2012: Infections are Common among HIV/HCV Coinfected Patients on Interferon


Life-threatening infections occur frequently among people with HIV and hepatitis C virus (HCV) coinfection during treatment with pegylated interferon plus ribavirin, but this does not appear to be a consequence of neutropenia, or loss of white blood cells, according to a poster presented at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012) this month on San Francisco.

Neutropenia and other blood cell deficiencies are well-known potential side effects of interferon-based therapy. Loss of pathogen-fighting neutrophils increases the risk of bacterial and other types of infections. People with HIV/HCV coinfection may fare worse because they also have impaired T-cell function.

Sergio Serrano-Villarfrom Hospital Universitario Ramón y Cajal in Madrid and colleagues conducted a prospective study that included 418 HIV positive patients with chronic hepatitis C who started treatment with pegylated alfa-2a (Pegasys) or alfa-2b (PegIntron) plus ribavirin between 2000 and 2011.

The participants had a median age of 41 years and most (88%) had a history of injection drug use. They had well-preserved immune function at baseline, with a median CD4 T-cell count close to 500 cells/mm3 (ranging from 342 to 696 cells/mm3).


"Infections are a common complication of treatment with [pegylated interferon/ribavirin] in HIV/HCV coinfected patients," the researchers concluded. "Most infections take place within the first 12 weeks of treatment and are exceptionally life-threatening." However, they added, pegylated interferon-induced neutropenia was not associated with the risk of infection."



S Serrano-Villar, CQuereda, A Moreno, et al. Neutropenia During Therapy with PegIFN and RBV and the Risk of Infections in HIV-infected Subjects with Chronic Hepatitis C (CHC). 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012). San Francisco. September 9-12, 2012. Abstract H-217.