Premium
Peginterferon‐alfa mono‐therapy in the treatment of acute hepatitis C in HIV ‐infection
Author(s) -
Boesecke C.,
Assen S.,
Stellbrink H.J.,
Baumgarten A.,
Ingiliz P.,
Strassburg C. P.,
SchwarzeZander C.,
Wasmuth J.C.,
Hoepelman A. I. M.,
Rockstroh J. K.,
Arends J. E.
Publication year - 2014
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12272
Subject(s) - medicine , ribavirin , gastroenterology , combination therapy , univariate analysis , hepatitis c , peginterferon alfa 2a , cohort , hepatitis c virus , immunology , multivariate analysis , virus
Summary The ongoing epidemic of acute hepatitis C ( AHC ) infection among MSM highlights the need to identify factors allowing for optimal treatment outcome in HIV co‐infected individuals. Cohort study of 105 HIV ‐infected patients with AHC infection from five centres in two E uropean countries was carried out. Choice of treatment with peg IFN ‐alfa alone (group 1; n = 36) or peg IFN ‐alfa and ribavirin ( RBV ) (group 2; n = 69) was at the discretion of the investigator. Outcome was evaluated as RVR and SVR . Fisher's exact and M ann W hitney U tests were used for statistical analysis. All patients were male, median age was 39 years, main route of transmission MSM (91%). In 69% of patients, clinical signs of acute hepatic infection were missing, dominant HCV genotypes were 1 (64%) and 4 (16%) and mean baseline HCV ‐ RNA was 3.559.085 IU /mL. 60% received HAART and CD 4 cell count was 469/mm 3 . Overall SVR rate was 64.8% (68/105). SVR was reached in 69% of treated patients in group 1 and in 63% of treated patients in group 2 ( P = 0.67) while RVR was seen in 61% and 49%, respectively ( P = 0.35). Interestingly, by univariate analysis, SVR rates in group 1 were significantly higher in patients initiating therapy within 4 weeks of AHC diagnosis compared to patients initiating therapy within 5–36 weeks after diagnosis ( P = 0.03). Peg IFN ‐alfa alone or in combination with ribavirin results in similar response rates in HIV ‐infected patients with AHC . In particular, when treatment is initiated within 4 weeks of diagnosis, peg IFN mono‐therapy might be sufficient to allow for an optimal treatment response.