AIDSWEEKLY Plus; Monday, June 7, 2004
Staff Medical Writers

According to a study from the American Foundation for AIDS Research, "Human immunodeficiency virus (HIV)-infected patients increasingly experience the consequences of chronic hepatitis C virus (HCV) coinfection. This trial randomized 107 patients coinfected with HIV and HCV to receive 48 weeks of interferon alfa-2b (IFN) 3 million units three times weekly plus either a full course of ribavirin (RBV) at 800 mg/day (group A, n = 53) or 16 weeks of placebo, followed by RBV (group B; n = 54)."

"The primary endpoint of sustained viral response (SVR) rate (undetectable HCV RNA at post-treatment week 24) was not different between groups A (11.3%) and B (5.6%; P = .32). Within group A, the SVR rate was lower in genotype 1 (2.5%) than in genotypes 2 through 4 (41.7%; P = .002). Fifty-five patients discontinued therapy prematurely, mostly because of adverse events or patient decisions," reported N. Brau and colleagues.

"At treatment week 12, the percentage of CD4⁺cells rose in group A (+4.1%; P < .001), but not in group B (-0.3%)," investigators continued. "A significant proportion (22%) of patients who were HIV viremic at baseline had undetectable HIV RNA at week 12. By week 16, the hemoglobin level decreased more in group A (-2,52 g/dL) than in group B (-1.02 g/dL; P < .001). In group A, the hemoglobin decline was steeper in patients receiving zidovudine (azidothymidine [AZT], -3.64 g/dL vs. no AZT, -2.08 g/dL), and patients receiving zidovudine had more anemia-related RBV dose reductions (AZT, 60% vs. no AZT, 16%)."

Brau suggested, "HCV therapy with IFN plus RBV is relatively safe in patients coinfected with HIV and HCV, but frequent treatment discontinuations and anemia-related RBV dose reductions contribute to a poor SVR rate. Control of HIV infection improves rather than worsens during therapy."

Brau and colleagues published the results of their research in Hepatology (Treatment of chronic hepatitis C in HIV/HCV-coinfection with interferon alpha-2b+ full-course vs 16-week delayed ribavirin. Hepatology. 2004 Apr;39(4):989-98.

For additional information, contact J.J. Smith, American Foundation AIDS Research, 120 Wall St., 13th Floor, New York, NY 10005, USA.

The publisher of the journal Hepatology can be contacted at: John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA.

The information in this article comes under the major subject areas of AIDS and HIV, Hepatitis C Virus, Hepatology, Immunology, Genotyping and Viral Therapy.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Brau N, Rodriguez-Torres M, Prokupek D, et al. "Treatment of chronic hepatitis C in HIV/HCV-coinfection with interferon alpha-2b+ full-course vs. 16-week delayed ribavirin", Hepatology. 2004 Apr;39(4):989-98.

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