Premium
Peg‐interferon and ribavirin treatment in HIV / HCV co‐infected patients in Thailand: efficacy, safety and pharmacokinetics
Author(s) -
Smolders E. J.,
Thammajaruk N.,
Kanter C. T. M. M.,
Colbers A.,
Chaiyahong P.,
Cuprasitrut T.,
Chittmittraprap S.,
Apornpong T.,
Khemnark S.,
Tangkijvanich P.,
Burger D. M.,
Avihingsa A.
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13027
Subject(s) - ribavirin , virology , medicine , pharmacokinetics , pegylated interferon , interferon , human immunodeficiency virus (hiv) , immunology , pharmacology , virus , hepatitis c virus
Objective In Thailand, 7.2% of HIV patients are co‐infected with hepatitis C virus ( HCV ), and these patients are treated with peg‐interferon + ribavirin ( PR ) for their HCV infection. This study evaluates efficacy and safety of PR treatment and pharmacokinetics of ribavirin in this population. Methods HIV / HCV co‐infected Thai patients were treated with PR for 24 or 48 weeks. Sustained virological response 24 weeks after the end of treatment ( SVR 24) was used to describe efficacy. (laboratory) safety parameters and ribavirin plasma concentrations were evaluated during study visits. Ribavirin concentrations were compared with t ‐tests for patients with and without anaemia (haemoglobin <10 g/dl) and SVR 24. Results A total of 101 HIV / HCV co‐infected patients were included; 88% were male ( n = 88), and 46% were infected with genotype 3. The median ( IQR ) start dose was 14.28 mg/kg/day. SVR 24 rate was 56%. All patients reported at least one (serious) adverse event, of which 28% of patients developed anaemia. Seven patients discontinued treatment due to toxicity issues. Geometric mean ( IQR ) ribavirin concentration was 1.81 (1.42–2.32) mg/l at week 8 of treatment. At week 8, patients with and without anaemia and SVR had ribavirin concentrations of 2.29 and 1.63 mg/l and 1.91 and 1.74 mg/l, respectively. Conclusions PR treatment has comparable response rates and toxicity profile in Thai HIV / HCV co‐infected patients as in Western HIV / HCV patients. However, ribavirin plasma concentrations were comparable with previously published studies in HIV / HCV co‐infected patients, but both, just as SVR rate, were lower than in mono‐infected patients.