Peginterferon plus ribavirin for chronic hepatitis C in patients with human immunodeficiency virus

TY - JOUR

T1 - Peginterferon plus ribavirin for chronic hepatitis C in patients with human immunodeficiency virus

AU - Gluud, Lise Lotte

AU - Marchesini, Emanuela

AU - Iorio, Alfonso

N1 - Keywords: Adult; Antiviral Agents; Drug Therapy, Combination; Female; HIV Infections; Hepatitis C, Chronic; Humans; Interferon Alfa-2a; Interferon Alfa-2b; Male; Middle Aged; Polyethylene Glycols; Ribavirin

PY - 2009

Y1 - 2009

N2 - 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 > or =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 microg/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.

AB - 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 > or =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 microg/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.

U2 - 10.1038/ajg.2009.311

DO - 10.1038/ajg.2009.311

M3 - Journal article

C2 - 19513022

SN - 0002-9270

VL - 104

SP - 2335-41; quiz 2342

JO - The American Journal of Gastroenterology

JF - The American Journal of Gastroenterology

IS - 9

ER -