Article ; Online: Pegylated interferon-α monotherapy leads to low response rates in HIV-infected patients with acute hepatitis C.
2011 Volume 16, Issue 7, Page(s) 979–988
Abstract: Background: Despite a rising incidence of acute HCV in patients infected with HIV, the optimal therapeutic strategy (pegylated interferon-α [PEG-IFN-α] monotherapy or in combination with ribavirin) is still under debate.: Methods: A total of 23 HIV- ... ...
| Abstract | Background: Despite a rising incidence of acute HCV in patients infected with HIV, the optimal therapeutic strategy (pegylated interferon-α [PEG-IFN-α] monotherapy or in combination with ribavirin) is still under debate. Methods: A total of 23 HIV-infected patients were prospectively diagnosed with acute HCV and treated with PEG-IFN-α2a monotherapy (180 μg/week) for 24 or 48 weeks. Add-on ribavirin was allowed from week 4 of therapy onwards. There were three patients who were not included for different reasons. Blood samples were routinely drawn for viral load measurement and IL28B polymorphism analysis. Results: Spontaneous viral clearance occurred in 1 (4%) patient. Nineteen patients (13 genotype 1 and 6 genotype 4) received treatment with PEG-IFN-α monotherapy (3 with add-on ribavirin) resulting in a rapid virological response (HCV RNA<50 IU/ml at week 4) in 7 (37%) patients. A sustained virological response (SVR) was reached in 7 (37%) patients, whereas 9 (47%) patients were null-responders to treatment (that is, <2 log₁₀ drop in HCV RNA at week 12 of therapy). The unfavourable G allele of the IL28B polymorphism rs8099917 was detected in 66% of the non-responders. In case of re-emergence of HCV viraemia after treatment discontinuation, sequence analysis of quasispecies confirmed an HCV relapse in 3 patients while 2 patients were re-infected by their previously non-responding partner. Conclusions: PEG-IFN-α monotherapy resulted in a low SVR rate and a high percentage of null-response, whereas non-SVR was associated with a polymorphism in the IL28B gene (rs8099917). |
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| MeSH term(s) | Adult ; Alleles ; Antiviral Agents/administration & dosage ; Antiviral Agents/therapeutic use ; Cohort Studies ; Female ; Genotype ; HIV Infections/complications ; HIV Infections/drug therapy ; Hepacivirus/drug effects ; Hepatitis C/complications ; Hepatitis C/drug therapy ; Hepatitis C/genetics ; Humans ; Interferon-alpha/administration & dosage ; Interferon-alpha/therapeutic use ; Interferons ; Interleukins/genetics ; Male ; Middle Aged ; Polyethylene Glycols/administration & dosage ; Polyethylene Glycols/therapeutic use ; Polymorphism, Single Nucleotide ; Prospective Studies ; RNA, Viral/blood ; RNA, Viral/genetics ; Recombinant Proteins/administration & dosage ; Recombinant Proteins/therapeutic use ; Recurrence ; Ribavirin/administration & dosage ; Ribavirin/therapeutic use ; Treatment Outcome ; Viral Load | ||||||||||
| Chemical Substances | Antiviral Agents ; interferon-lambda, human ; Interferon-alpha ; Interleukins ; RNA, Viral ; Recombinant Proteins ; Polyethylene Glycols (3WJQ0SDW1A) ; Ribavirin (49717AWG6K) ; Interferons (9008-11-1) ; peginterferon alfa-2a (Q46947FE7K) | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2011-10-12 | ||||||||||
| Publishing country | England | ||||||||||
| Document type | Journal Article ; Research Support, Non-U.S. Gov't | ||||||||||
| ZDB-ID | 1339842-8 | ||||||||||
| ISSN | 2040-2058 ; 1359-6535 | ||||||||||
| ISSN (online) | 2040-2058 | ||||||||||
| ISSN | 1359-6535 | ||||||||||
| DOI | 10.3851/IMP1843 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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