Important note: Information in this article was accurate in August 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, August 14, 2000
Prepared by AIDS Weekly editors from staff and other reports
NewsRx -- Clinical data from a French multicenter trial show that HIV coinfection does not adversely affect antiviral therapy for hepatitis C virus (HCV) infection.
"The aim of this prospective study was to compare the response to alfa-interferon treatment of chronic hepatitis C in two groups of patients: co-infected with HIV (G I) or not (G II)," stated X. Causse and colleagues, CHR Orleans Source, Hepatogastroenterology Unit, France. "One hundred and fifty-three patients with chronic hepatitis C had been enrolled in 30 French liver units or infectious diseases units between May 1992 and January 1995 (G I: 76, G II: 77) to receive alfa-2a interferon: 3 MU thrice weekly for six months."
Causse et al. published the results of their study in the Journal of Hepatology ("Does HIV infection influence the response of chronic hepatitis C to interferon treatment? A French multicenter prospective study," J Hepatol 2000 Jun;32(6):1003-10.
There were 63 patients in G I, and 64 patients in G II (total of 127) that fulfilled all the study criteria for analysis. The researchers reported that the two groups had comparable demographic data. However, there were significantly more severe biological and histological (p=0.001) parameters associated with worse hepatitis among the HIV-HCV coinfected patients.
"HCV viremia was higher among HIV coinfected patients (p=0.0169), while genotype repartition was identical among the two groups (more than 52% of genotype 1, more than 31% of genotype 3)," added Causse et al. "Alanine aminotransferase [ALT] normalization was, respectively, (G I/G II) obtained in 17.46%/26.56% (not significant) of patients at the end of treatment and in 11.11%/12.5% (not significant) of patients after six months of follow-up."
The researchers conducted multivariate analysis of the two groups for risk factors. They found that the GGT level before therapy (relative risk 2.1; 95% confidence interval ,1.1-5.8) and body surface area (relative risk 1.9; 95% ci, 1.1-3.7) were variables that were independently associated with the patients' responses to alfa-interferon treatment. They also found that higher GGT and more elevated body surface area were associated with a risk of non-response.
"In our study HIV infection did not affect the alfa-interferon treatment response of chronic hepatitis C, and response could be achieved among HIV coinfected patients," Causse et al. concluded. "Present therapeutic anti-HCV schedules need to be proposed to HIV-HCV coinfected patients before severe immunosuppression occurs.
"On the other hand, more severe biological and histological parameters were observed among HIV-HCV coinfected patients, which suggests a need to study whether HIV infection is associated with a worsening course of chronic hepatitis C."
The corresponding author for this report is X. Causse, CHR Orleans Source, Hepatogastroenterology Unit, BP 6709, F-45067 Orleans 2, France.
A search of the www.NewsRx.com online database using the terms "HIV" and "HCV" and "interferon" generated 86 articles.
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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