24 Weeks of HCV Treatment May Be Adequate for HIV Patients Coinfected with HCV Genotype 2 or 3

The aim of this open-label, single-centre, prospective study was to assess the efficacy, safety and tolerability of pegylated interferon (PegIntron) and ribavirin in HIV/hepatitis C virus (HCV)-coinfected patients, prescribed for the same duration and at the same dosage as that used in HCV monoinfection studies.

Forty-five patients coinfected with HIV and HCV with CD4 counts >200 cells/microliter were treated with pegylated interferon alfa-2b (PegIntron) 1.5 microgram/kg/week and ribavirin 1000-1200 mg/day for 24-48 weeks depending on HCV genotype.

Safety and tolerability were assessed weekly for the first month and monthly thereafter. Virological response was assessed at weeks 4, 12 and 24 and at the end of treatment and 12 and 24 weeks post completion of treatment.

The primary endpoint was defined as undetectable HCV RNA at 24 weeks post completion of treatment [sustained virological response (SVR)].

Results The majority of patients was male and had been injecting drug users. Sixty per cent were on antiretroviral therapy. In an intention-to-treat analysis, 53% had an SVR (genotype 1, 19% and genotype 2/3, 75%). All patients who had undetectable HCV RNA at week 4 of HCV treatment [very early virological response (VEVR)] had a SVR. On multivariate analysis only HCV genotype predicted SVR. Adverse events occurred frequently.

The authors conclude, "These results indicate that 24 weeks of HCV treatment may be adequate for HIV-infected individuals coinfected with HCV genotype 2 or 3."

"VEVR can predict SVR in this group and may be used to guide the subgroup of genotype 2/3 individuals who will respond to 24 weeks of treatment."

05/12/06

Reference
S Hopkins, J Lambourne, G Farrell, and others. Role of individualization of hepatitis C virus (HCV) therapy duration in HIV/HCV-coinfected individuals. HIV Medicine 7(4): 255-260. 2006.