Am J Gastroenterol. 2009 Jun 9. [Epub ahead of print]

Peginterferon Plus Ribavirin for Chronic Hepatitis C in Patients With Human
Immunodeficiency Virus.

Gluud LL, Marchesini E, Iorio A.
[1] Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical
Intervention Research,

Rigshospitalet, Copenhagen, Denmark [2] Department of Internal Medicine,
Gentofte University Hospital, Hellerup, Denmark.

OBJECTIVES:The aim of this study was to assess the effects of peginterferon plus
ribavirin for chronic hepatitis C in patients with human immunodeficiency virus
(HIV).

METHODS:Trials were identified through manual and electronic searches.
Randomized trials comparing peginterferon plus ribavirin with other antiviral
treatments for patients with chronic hepatitis C and HIV were included. The
primary outcome measure was virological response at the end of treatment and
after>/=6 months (sustained). Intention-to- treat meta-analyses including data
on all patients who were randomized were carried out.

RESULTS:Seven randomized trials were eligible for inclusion. The patients
included had chronic hepatitis C and stable HIV and were not previously treated
with interferon or ribavirin (treatment naive). The mean dosages were 180 or 1.5
mug/kg once weekly for peginterferon and 800 mg daily for ribavirin. The
treatment duration ranged from 24 to 48 weeks. Peginterferon plus ribavirin
increased the proportion of patients with an end-of-treatment or sustained
virological response compared with interferon plus ribavirin or peginterferon
alone. In subgroup analyses of trials comparing peginterferon plus ribavirin
with interferon plus ribavirin, the proportion with a sustained virological
response was 26% (109 of 423) for patients with genotype 1 or 4 and 57% (130 of
230) for genotype 2 or 3. Several adverse events occurred, including fatal
lactic acidosis and liver failure, but there were no significant differences in
mortality rates between treatment groups.

CONCLUSIONS: Peginterferon plus ribavirin may be considered for treatment-naive
patients with HIV and chronic hepatitis C. Adverse events should be monitored
carefully.

Am J Gastroenterol advance online publication, 9 June 2009; doi:10.1038/
ajg.2009. 311.

PMID: 19513022 [PubMed - as supplied by publisher]


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