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Pegylated Interferon Alfa-2a (Pegasys) with or without Ribavirin
in HIV-HCV Coinfection
Peginterferon
plus ribavirin combination therapy (PegIntron or Pegasys plus ribavirin)
is the current standard of care in the US and Europe for
the treatment of monoinfection with chronic hepatitis C. In February
2005, the US Food and Drug Administration (FDA) approved peginterferon
alfa-2a (Pegasys) and ribavirin (Copegus) for the treatment of chronic hepatitis C
in patients coinfected with
hepatitis C and HIV.
Researchers
at the University of California in San Francisco evaluated the safety
and efficacy of peginterferon alpha-2a (pegIFNalpha-2a) [Pegasys], with or without ribavirin,
in 154 HCV/HIV coinfected patients.
All
received pegIFNalpha-2a (180 microg/week) for 12 weeks, with those
achieving an early
virologic response (EVR) continued on monotherapy
through week 48.
Patients
without an EVR were randomized at week 14 to also receive ribavirin
(800 mg/day) or placebo through week 48.
Patients
with detectable HCV RNA at week 24 were discontinued.
Results
·
An
EVR occurred in 59 of 154 patients on Pegasys monotherapy, and
a sustained virologic
response (SVR) occurred in 19 of 55 of those achieving
an EVR and continuing monotherapy through week 48.
·
One
week 12 nonresponder
receiving pegIFNalpha-2a plus ribavirin, and none receiving pegIFNalpha-2a
plus placebo, achieved a SVR.
·
Treatment
discontinuations for adverse
events occurred in 10 of 154 patients before, and 16
of 131 after, week 14. HIV RNA and CD4 counts did not change significantly
during treatment.
The
authors conclude, “PegIFNalpha-2a was therefore at least as effective
as standard
interferon and ribavirin combination therapy and
was well tolerated, without a negative impact on HIV parameters.”
University of California, San Francisco,
San Francisco, California, USA.
07/18/05
Reference
M Khalili
and others. Pegylated interferon alpha-2a with or without ribavirin
in HCV/HIV coinfection: partially blinded, randomized multicenter
trial. Digestive Diseases and Sciences
50(6):1148-55. June 2005.
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