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Boosted Interferon Achieves Sustained Virologic Response With Reduced Liver Complications in Patients With HIV/Hepatitis C: Presented at CROI

By Maria Bishop

BOSTON, MA -- February 8, 2008 -- Interferon boosted with ribavirin (IFN+RBV) allows patients who are coinfected with HIV and hepatitis C virus (HCV) to achieve a long-term sustained virologic response while reducing liver complications and mortality.

These findings were presented here on February 4 at the 15th Conference on Retroviruses and Opportunistic Infections (CROI).

Juan Berenguer, MD, Infectious Diseases-HIV Unit, Hospital Gregorio Marañón, Madrid, Spain, led a team of clinical researchers in an analysis of the Grupo de Estudio del SIDA (GESIDA) 3603 Study Cohort. The GESIDA study was established to follow HIV/HCV patients who started therapy with boosted interferon between January 2000 and December 2005.

Overall, 711 coinfected patients were analyzed. Most participants had been treated with ribavirin-boosted pegylated interferon (44% with pegylated interferon alfa-2a; 38% with pegylated interferon alfa-2b); 18% had received conventional (non-pegylated) interferon plus ribavirin.

All subjects were followed every 6 months after completion of treatment, for a median of 20 months.

A Cox regression analysis was adjusted for Center for Disease Control (CDC) clinical category, HCV genotype, and stage of liver fibrosis.

Results demonstrated that patients who achieved a sustained virologic response on interferon plus ribavirin had a decreased risk of developing a liver-related event compared with those who did not achieve a sustained virologic response. The rate of liver-related mortality was 0.23 per 100 person-years versus 1.65 per 100 person-years, respectively; rates of liver decompensation were 0.23 versus 4.33, respectively; rates of hepatocarcinoma were 0 versus 0.83, respectively; rates of liver transplantation were 0 versus 1.02, respectively.

Rates of overall mortality in the two groups were 0.46 per 100 person-years versus 3.12 per 100 person-years, respectively.

HIV-positive patients with chronic HCV experienced a more rapid progression of liver disease in general than did patients with HCV alone.

It has been demonstrated that achievement of sustained virologic response, or continued undetectable HCV viral loads 6 months after completing hepatitis C treatment, reduces progression of liver disease. The long-term benefits of treatment response in coinfected individuals remain unknown.

The long-term clinical consequences of this trial are significant, the study authors concluded.


[Presentation title: Sustained Virological Response to Interferon Plus Ribavirin Reduces Liver-Related Complications and Mortality in HIV/HCV Co-Infected Patients. Abstract 60]

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