Critical role of ribavirin for the achievement of early virological response to HCV therapy in HCV/HIV-coinfected patients
| Autor: | Belén Ramos, Echevarría S, Antonio Ocampo, Piedad Arazo, Celia Miralles, Vincent Soriano, Javier García-Samaniego, Josep M. Guardiola, Miguel Angel Berdún, Pablo Barreiro, M. Romero, Iria Santos, Pablo Labarga, Elena Losada, Marina Núñez, Ana Rendón |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Endpoint Determination Hepatitis C virus Human immunodeficiency virus (HIV) HIV Infections Hepacivirus Interferon alpha-2 medicine.disease_cause Gastroenterology Antiviral Agents Polyethylene Glycols Virological response chemistry.chemical_compound Acquired immunodeficiency syndrome (AIDS) Species Specificity Pegylated interferon Virology Internal medicine Ribavirin medicine Humans Hepatology business.industry virus diseases HIV Interferon-alpha Hepatitis C medicine.disease digestive system diseases Recombinant Proteins Infectious Diseases Treatment Outcome chemistry Spain Immunology Coinfection RNA Viral Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Journal of viral hepatitis. 14(6) |
| ISSN: | 1352-0504 |
| Popis: | The response to hepatitis C virus (HCV) therapy seems to be lower in HCV/HIV-coinfected patients than in HCV-monoinfected individuals. Given that most pivotal trials conducted in coinfected patients have used the combination of pegylated interferon (pegIFN) along with fixed low doses (800 mg/day) of ribavirin (RBV), it is unclear whether HIV itself and/or suboptimal RBV exposure could explain this poorer outcome. Two well-defined end points of early virological response were evaluated in Peginterferon Ribavirina España Coinfección (PRESCO), a multicentre trial in which the combination of pegIFN plus RBV (1000 mg if body weight75 kg and 1200 mg if75 kg) was prescribed to coinfected patients. For comparisons, we used unpublished data from early kinetics in two other large trials, one performed in HIV-negative patients [Pegasys International Study Group (PISG)] in which RBV 1000-1200 mg/day was used and another [AIDS Pegasys Ribavirin Coinfection Trial (APRICOT)] in which HIV-positive patients received fixed low RBV doses (800 mg/day). A total of 348 HCV/HIV-coinfected patients from the PRESCO trial were analysed as well as all patients treated with pegIFN plus RBV, who completed 12 weeks of therapy in the comparative studies (435 in PISG and 268 in APRICOT). Negative serum HCV-RNA at week 4 (which has the highest positive predictive value of sustained virological response, SVR) was attained in 33.3%, 31.2% and 13% of treated patients with HCV genotype 1, respectively, in PRESCO, PISG and APRICOT. For HCV genotypes 2/3, responses were 83.7%, 84.2% and 37%, respectively. A decline lower than 2 log(10) at week 12 (which has the highest negative predictive value of SVR) was seen in 25.5%, 19.5% and 37% of HCV genotype-1-infected patients, and in 2.1%, 2.9% and 12% of genotypes-2/3-infected patients, respectively. Prescription of high RBV doses enhances the early virological response to HCV therapy in HCV/HIV-coinfected patients, with results approaching those seen in HCV-monoinfected patients. |
| Databáze: | OpenAIRE |
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