Literature DB >> 19772388

Efficacy and safety of pegylated interferon plus ribavirin in HIV and hepatitis C virus-coinfected patients with advanced immunosuppression.

José A Mira1, Alicia Gutiérrez-Valencia, Ignacio de los Santos Gil, Dolores Merino, Antonio Rivero, María J Ríos-Villegas, Marcial Delgado, Mercedes González-Serrano, Antonio Collado, Manuel Torres-Tortosa, Mohamed Omar, Miguel Angel López-Ruz, Juan Macías, Sari Arponen, Juan A Pineda.   

Abstract

BACKGROUND: The aim of this study was to assess the efficacy and safety of pegylated interferon (IFN) plus ribavirin (RBV) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected patients with severe immunodeficiency in a clinical cohort. BACKGROUND. A total of 542 HIV-infected patients receiving treatment with pegylated IFN plus RBV from June 2001 through April 2007 were included in this study. The outcome variables were sustained virologic response (SVR) rate and the emergence of AIDS-defining events during HCV infection therapy. SVR rates among patients with a CD4 cell count <or=250 cells/mm(3) at baseline were compared with those among patients with CD4 cell counts >250 cells/mm(3). The association between SVR and potential predictors was analyzed.
RESULTS: Ten (26%) of 39 individuals with a baseline CD4 cell count 250 cells/mm(3) and 198 (39%) of 503 with baseline CD4 cell counts >or=250 CD4 cells/mm(3) achieved SVR (P = .09). In a nested case-control study with populations matched at a 1:2 ratio, the SVR rate was 26% in the CD4 cell count 250 cells/mm(3) group and 32% in the CD4 cell count >250 cells/mm(3) group (P = .5). Baseline CD4 cell count (250 cells/mm(3) vs >250 cells/mm(3)) was not associated with SVR in the multivariate analysis. Two (5%) individuals in the CD4 cell count 250 cells/mm(3) group experienced opportunistic events during follow-up. In the CD4 cell count 250 cells/mm(3) group, severe hematological toxicity and pegylated IFN or RBV dosage reductions occurred in 16 (41%) and 12 (31%) patients, respectively. In the CD4 cell count >250 cells/mm(3) group, severe hematological toxicity and pegylated IFN or RBV dosage reductions occurred in 29% (P = .1) and 20% (P = .1) of patients, respectively.
CONCLUSIONS: The efficacy of pegylated IFN plus RBV in HIV-HCV-coinfected patients with advanced immunosuppression is substantial and not significantly different to that observed in the overall coinfected population. HCV therapy is generally safe in the population of coinfected patients with advanced immunosuppression.

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Year:  2009        PMID: 19772388     DOI: 10.1086/605677

Source DB:  PubMed          Journal:  Clin Infect Dis        ISSN: 1058-4838            Impact factor:   9.079


  4 in total

Review 1.  Liver disease in the HIV-infected individual.

Authors:  Jennifer C Price; Chloe L Thio
Journal:  Clin Gastroenterol Hepatol       Date:  2010-09-17       Impact factor: 11.382

Review 2.  The treatment of chronic hepatitis C virus infection in HIV co-infection.

Authors:  Martin Vogel; Jürgen K Rockstroh
Journal:  Eur J Med Res       Date:  2009       Impact factor: 2.175

3.  The influence of HAART on the efficacy and safety of pegylated interferon and ribavirin therapy for the treatment of chronic HCV infection in HIV-positive Individuals.

Authors:  M Vogel; G Ahlenstiel; B Hintsche; S Fenske; A Trein; T Lutz; D Schürmann; C Stephan; P Khaykin; M Bickel; C Mayr; A Baumgarten; P Buggisch; H Klinker; C John; J Gölz; S Staszewski; J K Rockstroh
Journal:  Eur J Med Res       Date:  2010-03-30       Impact factor: 2.175

Review 4.  Treatment outcomes of treatment-naïve Hepatitis C patients co-infected with HIV: a systematic review and meta-analysis of observational cohorts.

Authors:  Anna Davies; Kasha P Singh; Zara Shubber; Philipp Ducros; Edward J Mills; Graham Cooke; Nathan Ford
Journal:  PLoS One       Date:  2013-02-05       Impact factor: 3.240

  4 in total

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