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Role of Weight-Based Ribavirin Dosing and Extended Duration of Therapy in Chronic Hepatitis C in HIV-Infected Patients: The PRESCO Trial

2007; Mary Ann Liebert, Inc.; Volume: 23; Issue: 8 Linguagem: Inglês

10.1089/aid.2007.0011

1931-8405

Marina Núñez, Celia Miralles, Miguel Angel Berdún, Elena Losada, Koldo Aguirrebengoa, Antonio Ocampo, Piedad Arazo, Manuel Cervantes, Ignacio de los Santos, Isabel San Joaquín, Santiago Echeverría, María José Galindo, Víctor Asensi, Pablo Barreiro, Julio Sola, Juan José Hernandez-Burruezo, Josep M. Guardiola, Míriam Romero, Javier García‐Samaniego, Vincent Soriano,

Hepatitis B Virus Studies

The response to pegylated interferon (pegIFN) plus ribavirin (RBV) as treatment of chronic hepatitis C virus (HCV) infection is lower in HIV-coinfected than in HCV-monoinfected patients and could be due to suboptimal RBV dosing and/or insufficient duration of therapy in prior trials. In a prospective, multicenter, open, comparative trial, HCV/HIV-coinfected patients received pegIFN plus weight-based RBV for 48 or 72 weeks (HCV genotypes 1 and 4) and 24 or 48 weeks (HCV genotypes 2 and 3). Use of didanosine was not allowed. Out of 389 patients included in the trial, 61% were infected by HCV-1/4 and 67% had serum HCV-RNA >500,000 IU/ml. Sustained virological response (SVR) was achieved by 49.6%, significantly higher in HCV-2/3 than HCV-1/4 (72.4% vs. 35%; p < 0.0001). A high drop-out rate in the longer treatment arms precluded obtaining definitive conclusions about the efficacy of prolonging therapy. Premature treatment discontinuations due to serious adverse events occurred in 8.2%. Infection with HCV-2/3, lower baseline HCV-RNA, and negative HCV-RNA at week 12 were all independent predictors of SVR in the multivariate analysis. The use of RBV 1000–1200 mg/day plus pegIFN is relatively safe and provides SVR in nearly half of coinfected patients, twice as high in HCV-2/3 than HCV-1/4.