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Efficacy of pegIFN-alfa, pegIFN-alfa/RBV similar in patients with HCV/HIV coinfection
Peginterferon-alfa monotherapy was comparably effective in the treatment of acute hepatitis C in patients coinfected with HIV compared with peginterferon-alfa/ribavirin combination therapy, according to research data.
Researchers performed an observational cohort study of 105 male patients (median age, 39 years) infected with both acute hepatitis C (HCV) and HIV. Patients were treated with either pegIFN-alfa monotherapy (n=36) or pegIFN-alfa/RBV combination therapy (n=69) at five centers in Germany and the Netherlands between 2002 and 2010. Clinical signs of acute hepatic infection were absent in 69% of the cohort, and predominant HCV genotypes were 1 and 4, accounting for 64% and 16% of the cohort, respectively.
Overall rate of sustained virologic response (SVR) was 64.8%, with 69% of the monotherapy group achieving SVR compared with 63% of the combination therapy group (P=.67). Rapid virologic response was seen in 61% of the monotherapy group compared with 49% of the combination therapy group (P=.35). Among the monotherapy group, SVR rate was higher when treatment was initiated within 4 weeks of HCV diagnosis compared with 5 to 36 weeks after diagnosis (89% vs. 50%; P=.03).
“In this study, we clearly showed that pegIFN-alfa monotherapy was similarly effective as pegIFN-alfa/RBV combination therapy in the treatment of acute [HCV] in HIV-infected patients,” the researchers concluded. “HIV coinfection and duration of HCV infection before treatment initiation are the most likely factors influencing [acute HCV] treatment outcome. If treatment is initiated early (within 4 weeks after diagnosis) [pegIFN] monotherapy might be sufficient to obtain similar response rates.”
Disclosure: See the study for a full list of relevant financial disclosures.