Literature DB >> 23450124

Optimizing hepatitis C therapy in HIV/hepatitis C virus (HCV) coinfected patients: Analysis of HCV viral kinetics on treatment.

Paul Damien James1, David Kh Wong.   

Abstract

INTRODUCTION: Hepatitis C virus (HCV) infection is potentially curable, but the sustained virological response (SVR) has been shown to be lower in patients coinfected HIV. A single-centre experience treating individuals with HCV and HIV coinfection is reported.
METHODS: Twenty-one patients who received standard doses of pegylated interferon with weight-based dosing of ribavirin (mean 14.3 mg/kg) were retrospectively reviewed. Qualitative HCV polymerase chain reaction (PCR) was performed prospectively every four weeks if the patient remained HCV PCR positive. All patients with HCV genotype 1 were treated for 48 weeks. Patients with genotype 2 or 3 were treated for 24 weeks and 32 weeks to 36 weeks if their HCV RNA level was undetectable after four weeks (RVR4) or eight weeks (RVR8) of therapy, respectively. If RVR8 was not achieved, the treatment was continued for 48 weeks.
RESULTS: There were no dropouts or dose reductions within the first 12 weeks of treatment. SVR status was available for 20 patients and adequate serum for viral kinetics analyses was available for 17 patients. Eighty per cent of the patients achieved SVR (50% genotype 1; 100% genotypes 2 and 3). The week 8 viral load remained elevated for all genotype 1 nonresponders. DISCUSSION: High effectiveness rates were seen, particularly in patients with HCV genotype 2 and 3 who were treated for shorter durations. HCV viral loads after eight weeks of therapy helped distinguish patients with HCV genotype 1 who would respond to therapy.
INTRODUCTION: Hepatitis C virus (HCV) infection is potentially curable, but the sustained virological response (SVR) has been shown to be lower in patients coinfected HIV. A single-centre experience treating individuals with HCV and HIV coinfection is reported.
METHODS: Twenty-one patients who received standard doses of pegylated interferon with weight-based dosing of ribavirin (mean 14.3 mg/kg) were retrospectively reviewed. Qualitative HCV polymerase chain reaction (PCR) was performed prospectively every four weeks if the patient remained HCV PCR positive. All patients with HCV genotype 1 were treated for 48 weeks. Patients with genotype 2 or 3 were treated for 24 weeks and 32 weeks to 36 weeks if their HCV RNA level was undetectable after four weeks (RVR4) or eight weeks (RVR8) of therapy, respectively. If RVR8 was not achieved, the treatment was continued for 48 weeks.
RESULTS: There were no dropouts or dose reductions within the first 12 weeks of treatment. SVR status was available for 20 patients and adequate serum for viral kinetics analyses was available for 17 patients. Eighty per cent of the patients achieved SVR (50% genotype 1; 100% genotypes 2 and 3). The week 8 viral load remained elevated for all genotype 1 nonresponders. DISCUSSION: High effectiveness rates were seen, particularly in patients with HCV genotype 2 and 3 who were treated for shorter durations. HCV viral loads after eight weeks of therapy helped distinguish patients with HCV genotype 1 who would respond to therapy.

Entities:  

Keywords:  Coinfection; Hepatitis C virus; Human immunodeficiency virus; Sustained virological response; Treatment; Viral load

Year:  2012        PMID: 23450124      PMCID: PMC3374464          DOI: 10.1155/2012/384630

Source DB:  PubMed          Journal:  Can J Infect Dis Med Microbiol        ISSN: 1712-9532            Impact factor:   2.471


  22 in total

1.  Limited effectiveness of antiviral treatment for hepatitis C in an urban HIV clinic.

Authors:  Shruti H Mehta; Gregory M Lucas; Lisa B Mirel; Michael Torbenson; Yvonne Higgins; Richard D Moore; David L Thomas; Mark S Sulkowski
Journal:  AIDS       Date:  2006-11-28       Impact factor: 4.177

2.  Integrating treatment for hepatitis C virus infection into an HIV clinic.

Authors:  Kathleen A Clanon; Juergen Johannes Mueller; Michael Harank
Journal:  Clin Infect Dis       Date:  2005-04-15       Impact factor: 9.079

3.  Coinfection with hepatitis viruses and outcome of initial antiretroviral regimens in previously naive HIV-infected subjects.

Authors:  Andrea De Luca; Roberto Bugarini; Alessandro Cozzi Lepri; Massimo Puoti; Enrico Girardi; Andrea Antinori; Antonio Poggio; Gabriella Pagano; Giulia Tositti; Gianpiero Cadeo; Antonio Macor; Mario Toti; Antonella D'Arminio Monforte
Journal:  Arch Intern Med       Date:  2002-10-14

4.  Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study.

Authors:  Rainer Weber; Caroline A Sabin; Nina Friis-Møller; Peter Reiss; Wafaa M El-Sadr; Ole Kirk; Francois Dabis; Matthew G Law; Christian Pradier; Stephane De Wit; Börje Akerlund; Gonzalo Calvo; Antonella d'Arminio Monforte; Martin Rickenbach; Bruno Ledergerber; Andrew N Phillips; Jens D Lundgren
Journal:  Arch Intern Med       Date:  2006 Aug 14-28

5.  Peginterferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients.

Authors:  Francesca J Torriani; Maribel Rodriguez-Torres; Jürgen K Rockstroh; Eduardo Lissen; Juan Gonzalez-García; Adriano Lazzarin; Giampiero Carosi; Joseph Sasadeusz; Christine Katlama; Julio Montaner; Hoel Sette; Sharon Passe; Jean De Pamphilis; Frank Duff; Uschi Marion Schrenk; Douglas T Dieterich
Journal:  N Engl J Med       Date:  2004-07-29       Impact factor: 91.245

6.  Peginterferon Alfa-2a plus ribavirin versus interferon alfa-2a plus ribavirin for chronic hepatitis C in HIV-coinfected persons.

Authors:  Raymond T Chung; Janet Andersen; Paul Volberding; Gregory K Robbins; Tun Liu; Kenneth E Sherman; Marion G Peters; Margaret J Koziel; Atul K Bhan; Beverly Alston; Dodi Colquhoun; Tom Nevin; George Harb; Charles van der Horst
Journal:  N Engl J Med       Date:  2004-07-29       Impact factor: 91.245

7.  Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose.

Authors:  Stephanos J Hadziyannis; Hoel Sette; Timothy R Morgan; Vijayan Balan; Moises Diago; Patrick Marcellin; Giuliano Ramadori; Henry Bodenheimer; David Bernstein; Mario Rizzetto; Stefan Zeuzem; Paul J Pockros; Amy Lin; Andrew M Ackrill
Journal:  Ann Intern Med       Date:  2004-03-02       Impact factor: 25.391

8.  Rapid and early virological response to chronic hepatitis C treatment with IFN alpha2b or PEG-IFN alpha2b plus ribavirin in HIV/HCV co-infected patients.

Authors:  Christopher Payan; Adeline Pivert; Patrice Morand; Samira Fafi-Kremer; Fabrice Carrat; Stanislas Pol; Patrice Cacoub; Christian Perronne; Françoise Lunel
Journal:  Gut       Date:  2007-03-15       Impact factor: 23.059

Review 9.  Management of hepatitis C virus infection in HIV/HCV co-infected patients: clinical review.

Authors:  Ashwani-K Singal; Bhupinderjit S Anand
Journal:  World J Gastroenterol       Date:  2009-08-14       Impact factor: 5.742

Review 10.  The challenge of hepatitis C in the HIV-infected person.

Authors:  David L Thomas
Journal:  Annu Rev Med       Date:  2008       Impact factor: 13.739

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  4 in total

1.  Response-guided therapy for hepatitis C genotype 2 and 3 in those with HIV coinfection.

Authors:  Lay Lay Win; Paul James; David K Wong
Journal:  Dig Dis Sci       Date:  2014-05-21       Impact factor: 3.199

Review 2.  Treatment decisions and contemporary versus pending treatments for hepatitis C.

Authors:  Paul M Trembling; Sudeep Tanwar; William M Rosenberg; Geoffrey M Dusheiko
Journal:  Nat Rev Gastroenterol Hepatol       Date:  2013-09-10       Impact factor: 46.802

3.  You're not the one: treating subjects co-infected with hepatitis C genotypes 2 and 3 and human immunodeficiency virus.

Authors:  Brian L Pearlman; Tanna H Lim
Journal:  Dig Dis Sci       Date:  2014-07-08       Impact factor: 3.199

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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