Chronic hepatitis C virus (HCV) infection is a cause of major complications in patients co-infected with HIV.
In this study, researchers from the United States compared peginterferon plus ribavirin with interferon plus ribavirin for the treatment of chronic hepatitis C in these patients.
The team randomized 133 patients to receive 1 of 2 treatments:
- 180 µg of peginterferon alpha-2a weekly for 48 weeks
- 6 million IU of interferon alpha-2a 3 times weekly for 12 weeks followed by 3 million IU 3 times weekly for 36 weeks.
All patients received ribavirin according to a dose-escalation schedule.
Patients with no virologic response underwent liver biopsy at week 24. Medications were continued in those with a virologic response or histologic improvement.
|Patients with HCV genotype 1 infection had a lower response to peginterferon plus ribavirin.|
|New England Journal of Medicine|
The researchers found that treatment with peginterferon and ribavirin resulted in a significantly higher rate of sustained virologic response interferon and ribavirin.
However, in the peginterferon group only 14% of patients with HCV genotype 1 infection had a sustained virologic response, compared with 73% with other HCV genotypes.
The team found histologic responses in 35% of subjects with no virologic response who underwent liver biopsy.
Dr Raymond Chung and colleagues concluded, "In persons infected with HIV, the combination of peginterferon and ribavirin is superior to the combination of interferon and ribavirin in the treatment of chronic hepatitis C".
"These regimens may provide clinical benefit even in the absence of virologic clearance".
"The marked discrepancy in the rates of sustained virologic response between HCV genotypes indicates that strategies are needed to improve the outcome in persons infected with HCV genotype 1".