Treatment of chronic hepatitis C in patients with human immunodeficiency virus (HIV) with weekly peginterferon alpha-2b plus ribavirin: a multi-centred Belgian study
Journal | Volume 72 - 2009 |
Issue | Fasc.4 - Original articles |
Author(s) | P. Michielsen, E. Bottieau, H. Van Vlierberghe, E. Van Marck, E. Vandemaele, M. Denys, J.P. Brasseur, M. Popan |
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(1) Division of Hepatogastroenterology, University Hospital Antwerp, Belgium ; (2) Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Belgium ; (3) Division of Hepatogastroenterology, University Hospital Ghent, Belgium ; (4) Division of Pathology, University Hospital Antwerp, Belgium ; (5) General Biomedical and Statistical Consulting, Gentbrugge, Belgium ; (6) Denys Research Consultants, Wetteren, Belgium ; (7) Medical Department, Schering-Plough, Brussels, Belgium. |
Background and study aims : In Belgium, 10-15% of patients infected with the human immunodeficiency virus (HIV) are co- infected with hepatitis C virus (HCV). Because of increased inci- dence of antiretroviral drug-related hepatotoxicity and more rapid clinical evolution towards end-stage liver disease, treatment of chronic hepatitis C becomes a priority. We report the results of a multi-centred Belgian study evaluating efficacy and safety of peginterferon alpha-2b plus ribavirin in HIV-HCV co-infected patients without AIDS and without decompensated liver disease. Patients and methods : Forty-one patients, all genotypes, were screened to participate. Eventually 37 received treatment with peginterferon alpha-2b (1.5 µg/kg/week) plus daily weight-based ribavirin for 52 weeks. About one third of the patients were geno- types 1, 2/3, and genotype 4, most of the latter being of Central African origin. About 56% of the patients had severe fibrosis (Metavir score ?? F3). Results : Sustained viral response (SVR) at 24 weeks of follow-up was observed in 10/37 (27%) of patients. SVR was higher in geno- type 2/3 compared to genotype 1/4 (46.7% versus 13.6% ; p = 0.06) and in low (F0-F1) versus high (F2-F4) grade fibrosis (p = 0.06). Treatment was withdrawn for side effects in 11/37 patients (30%). One Child A cirrhosis patient at the start of therapy died 7 months after treatment withdrawal as a result of severe haemolytic anaemia. Conclusions : It can be concluded that weight-based peginterfer- on alpha-2b plus ribavirin can be successful in selected HIV-HCV co-infected patients. Caution should be applied in patients with advanced liver disease. (Acta gastroenterol. belg., 2009, 72, 389-393). |
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