Peginterferon vs. interferon in the treatment of different HCV genotype infections in HIV patients.

It remains difficult to achieve high sustained response rates (SVRs) in chronic hepatitis patients coinfected with human immunodeficiency virus (HIV). The aim of this study was to perform a meta-analysis of randomized controlled trials (RCTs) comparing peginterferon with interferon in the treatment of patients carrying different genotypes of hepatitis C virus (HCV) and coinfected with HIV. A Medline literature search was conducted to identify RCTs evaluating SVRs to peginterferon and interferon in HCV/HIV-coinfected patients. Six studies matched the selection criteria, and the HCV genotype of 1,717 coinfected patients was reported. For genotypes 1 or 4 HCV and HIV-coinfected patients, both types of peginterferon, alpha-2a and alpha-2b, achieved higher SVRs compared with the respective types of interferon. The SVRs achieved in patients infected with HCV genotypes 1 or 4 treated with peginterferon and ribavirin was not satisfactory in comparison with those of patients infected with HCV genotypes 2 or 3 (26% vs. 55%). The probability of achieving higher SVRs in patients when treated with peginterferon plus ribavirin increased compared with other therapies, especially for patients coinfected with HCV genotypes 1 or 4 and HIV. The likelihoods of serious adverse effects and withdrawal rates were similar.