Lower ribavirin biodisponibility in patients with HIV-HCV coinfection in comparison with HCV monoinfected patients

Autor: Marie-Claude Gagnieu, Patrick Miailhes, Jean-Michel Livrozet, Fabien Zoulim, François Parant, François Bailly, Marianne Maynard, Pierre Chiarello, Giorgiana Hatu, Pierre Pradat, Emmanuel Pourcelot
Přispěvatelé: Service d'hépatologie, Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Médicine et Pharmacie 'Iuliu Hatieganu', Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pharmacologie, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'immunologie, BMC, Ed., Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
HIV Infections
medicine.disease_cause
030226 pharmacology & pharmacy
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Pegylated interferon
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
0303 health sciences
education.field_of_study
Human immunodeficiency virus
Coinfection
Area under the curve
virus diseases
Hepatitis C
Middle Aged
3. Good health
Infectious Diseases
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Female
medicine.drug
Research Article
Adult
medicine.medical_specialty
Combination therapy
Hepatitis C virus
Population
Biological Availability
Antiviral Agents
Ribavirin exposure
03 medical and health sciences
Young Adult
Internal medicine
Ribavirin
medicine
Humans
education
Aged
030306 microbiology
business.industry
Hepatitis C
Chronic
medicine.disease
Treatment
chemistry
Immunology
business
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, 2014, 14 (1), pp.150. ⟨10.1186/1471-2334-14-150⟩
BMC Infectious Diseases, BioMed Central, 2014, 14 (1), pp.150. ⟨10.1186/1471-2334-14-150⟩
ISSN: 1471-2334
Popis: International audience; BACKGROUND: In HIV infected patients, the impact of ribavirin (RBV) pharmacology on sustained virologic response (SVR) to hepatitis C virus (HCV) treatment has not been fully investigated. The objective of this study was to compare the early RBV plasma exposure between a population of HIV-HCV coinfected patients and an HCV monoinfected group. METHODS: Early RBV plasma exposure (expressed as Area Under the Curve (AUC) from 0 to 4 h) after a 600 mg first dose of RBV was measured in a population of HIV-HCV coinfected patients in comparison with an HCV monoinfected group. Peripheral blood samples were collected before the 600 mg RBV first dose (T0) to ensure no detectable baseline plasma RBV, and then 30 mn, 1, 2 and 4 hours after RBV intake (T0.5, T1, T2 and T4). RESULTS: Eighty-six patients with chronic hepatitis C entered the study among whom 23 (27%) were HIV-HCV coinfected. Coinfected patients had a significantly lower RBV-AUC(0-4h) (median: 1469 μg*h/L [range 936-3677]) compared with monoinfected patients (2030 μg*h/L [851-7700]; p = 0.018). This RBV under exposure in coinfected patients persisted after normalization of AUC to RBV dose per kilogram of body weight (182 μg*h/L [110-425] versus 271 μg*h/L [82-1091], p = 0.001). CONCLUSIONS: These results suggest that lower early bioavailability of RBV could be one of the reasons for lower SVR in HIV-HCV coinfected patients treated with pegylated interferon/RBV combination therapy. RBV plasma underexposure seems to be associated with the immunological status of the patients with lower AUC(0-4h) values observed in the more immunosuppressed coinfected patients.
Databáze: OpenAIRE
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