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Low SVR rates observed in HCV/HIV patients assigned peginterferon/ribavirin in clinical practice
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WASHINGTON — With liver disease now the leading cause of death among patients coinfected with HIV and hepatitis C, treatment of the HCV coinfection should be a key part of the care of HIV-infected patients, a speaker said here.
Yet only about 16% to 20% of HIV/HCV coinfected patients receive antiviral treatments for HCV, and combined therapy of pegylated interferon and ribavirin among these patients results in low rates of sustained virologic response in a clinical setting, George N. Ioannou, MD, MS, of the Veterans Affairs Puget Sound Health Care System in Seattle, said at The Liver Meeting.
“We identified in this large study of unselected patients with HIV/hepatitis C coinfection treated with pegylated interferon and ribavirin [PR] in a real-world setting that the SVR rate in genotype 1 patients was only 16.7%,” he said. “The SVR rate in genotype 2 or 3 patients was 44%.”
Researchers analyzed available data on 619 HIV/HCV coinfected patients who received antiviral PR treatment through the Veterans Affairs health care system between 2002 and 2009.
The data demonstrated a higher starting dose of ribavirin — 1,000 mg to 1,200 mg daily based on weight — was needed to achieve SVR in genotype 1 patients, but 800 mg per day was sufficient for genotype 2 and 3 patients. Use of erythropoietin during treatment also was independently associated with higher SVR rates.
Ioannou said the study was limited by its observational nature, specifically calling attention to the fact it could not prove a causal relationship between use of erythropoietin and higher SVR rates. It also was limited by a small sample size for genotypes 2 and 3 (n=116), he said.
“These low SVR rates obviously highlight the need for development and production of direct-acting antiviral agents for HIV/hepatitis C coinfected patients,” Ioannou concluded.
Disclosure: Ioannou reports no relevant financial disclosures.
For more information:
Ioannou GN. #37: Antiviral Treatment for Hepatitis C Virus in HIV/HCV Coinfected Patients. Presented at: The Liver Meeting 2013; Nov. 1-5, Washington.