Hepatitis C virus (HCV) infection is associated with substantial morbidity and mortality in patients co-infected with the human immunodeficiency virus (HIV).
In this study, an international team of researchers compared pegylated interferon alpha-2a plus either ribavirin or placebo with alpha-2a plus ribavirin in these patients.
The researchers included 868 persons who were infected with both HIV and HCV, and who had not previously been treated with interferon or ribavirin.
Patients were randomly assigned to receive 1 of 3 treatments:
- Peginterferon alpha-2a (180 µg per week) plus ribavirin (800 mg per day)
- Peginterferon alpha-2a plus placebo
- Interferon alpha-2a (3 million IU 3 times a week) plus ribavirin.
Patients were treated for 48 weeks and followed for an additional 24 weeks.
The primary end point was a sustained virologic response.
|Anemia was more common in patients treated with ribavirin.|
|New England Journal of Medicine|
The researchers found that the overall rate of sustained virologic response was significantly higher in patients receiving peginterferon alpha-2a plus ribavirin.
For HCV genotype 1, the team found that sustained virologic response was 29% for the peginterferon alpha-2a plus ribavirin group, 14% for the peginterferon alpha-2a plus placebo group, and 7% for the interferon alpha-2a plus ribavirin group.
The corresponding rates in patients with HCV genotype 2 or 3 were 62%, 36% and 20%.
Overall, neutropenia and thrombocytopenia were more common in patients treated with regimens that contained peginterferon alpha-2a.
Anemia was more common in patients treated with regimens containing ribavirin.
Dr Francesca Torriani and colleagues concluded, "Among patients infected with both HIV and HCV, the combination of peginterferon alpha-2a plus ribavirin was significantly more effective than either interferon alpha-2a plus ribavirin or peginterferon alpha-2a monotherapy".