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Early HCV dynamics on Peg-interferon and ribavirin in HIV/HCV co-infection

2004; Lippincott Williams & Wilkins; Volume: 18; Issue: 1 Linguagem: Inglês

10.1097/00002030-200401020-00007

1473-5571

À. Ballesteros, Sandra Franco, Daniel Fuster, Ramón Planas, Miguel Ángel Martı́nez, Lesly Acosta, Guillem Sirera, Anna Salas, Jordi Tor, Celestino Rey‐Joly, Bonaventura Clotet, Cristina Tural,

Chronic Lymphocytic Leukemia Research

Objectives: To describe the 28-day hepatitis C virus (HCV) kinetics under Pegylated-interferon (Peg-IFN) + ribavirin (RBV) therapy in HIV/HCV co-infected patients. To evaluate the predictive value of early virological response (EVR) of achieving a sustained virological response (SVR). To investigate the baseline mutations in the interferon sensitivity determining region (ISDR)2209–2248 in the non-structural 5A protein of HCV according to genotype. Methods: Open, prospective trial including 28 co-infected patients with directly observed treatment with Peg-IFN + RBV. We assessed the predictive values of EVR (≥ 2 log10 of HCV decay or a negative qualitative test) at days 1, 7, 28 and in week 12 of the SVR. Results: The SVR in an intention-to-treat analysis was 28.6% (genotype 1, 1/13; genotype 3, 6/10; genotype 4, 1/5). Patients who reached SVR presented a significantly faster HCV plasma viral load reduction compared to non-responders from the first 24 h [−1.06 log10 (interquartile range, −1.7 to −0.4) versus –0.05 log10 (interquartile range, −0.4 to +0.14) respectively; P = 0.002]. The median HCV viral load at week 12 was significantly different from that at baseline in responder and transient responders but not in non-responder patients. The positive predictive value was 100% within the first month and the best negative predictive value was 92% and 88.8% at weeks 4 and 12 respectively. The only genotype 1 responder patient had eight mutations in ISDR2209–2248. Conclusions: A very early HCV viral decay is observed in responder patients. An early virological response assessment at week 4 and 12 might be a useful tool in the clinical management of the co-infected population.