Response to pegylated interferon plus ribavirin in HIV-infected patients with chronic hepatitis C due to genotype 4

Author(s): Martín-Carbonero L, Puoti M, García-Samaniego J, De Luca A, Losada E, et al.


Hepatitis C virus (HCV) genotypes 1 and 4 respond less well to pegylated interferon (pegIFN) plus ribavirin (RBV) therapy. For this reason most studies merge these two genotypes when assessing virological response. However, in most trials the HCV genotype 4 population is rather small, and conclusions are mainly derived from what occurs in HCV-1 patients. All HCV-4 patients coinfected with HIV who received pegIFN plus RBV in two different multicentre studies, PRESCO and ROMANCE, conducted respectively in Spain and Italy, were retrospectively analyzed. Baseline plasma HCV-RNA, proportion of patients with HCV-RNA <10 IU / mL at week 4 (rapid virological response), and HCV-RNA declines >2 logs at week 12 (early virological response, EVR) were all assessed as predictors of sustained virological response (SVR). Overall, 75 patients (60 men) were evaluated. Median age was 40 years and median CD4 count 598 cells / mm(3); 49% had plasma HIV-RNA <50 copies / mL; 71% had elevated liver enzymes and 31% had advanced liver fibrosis (Metavir F3-F4). Median serum HCV-RNA was 5.7 log IU / mL. Rapid virological response was attained by 10 (20%) patients and EVR by 26 (42%). Using intention-to-treat and on-treatment (OT) analyses, SVR was achieved by 21 / 75 (28%) and 21 / 62 (34%) of HCV-4 patients, respectively. In the multivariate analysis (OT), baseline HCV-RNA (OR 0.09 for every log increment; 95% CI: 0.01-0.7) and EVR (OR: 7.08; 95% CI: 1.8-27.2) were significantly and independently associated with SVR. This is the largest series of HIV-infected patients with chronic hepatitis C due to HCV-4 treated with pegIFN plus RBV examined so far and the results show that HCV-4 behaves similarly to HCV-1. Therefore, these patients should be considered as difficult to treat population. Baseline serum HCV-RNA and EVR are the best predictors of SVR in HCV-4 / HIV-coinfected patients.

Similar Articles

Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome

Author(s): Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, et al.

Global burden of disease (GBD) for hepatitis C

Author(s): Global Burden Of Hepatitis C Working Group

The hepatitis C virus life cycle as a target for new antiviral therapies

Author(s): Pawlotsky JM, Chevaliez S, McHutchison JG

Global distribution and prevalence of hepatitis C virus genotypes

Author(s): Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, et al.

HCV genotypes among 1013 Saudi nationals: a multicenter study

Author(s): Al Traif I, Al Balwi MA, Abdulkarim I, Handoo FA, Alqhamdi HS, et al.

Genetic epidemiology of hepatitis C virus throughout egypt

Author(s): Ray SC, Arthur RR, Carella A, Bukh J, Thomas DL

Telaprevir activity in treatment-naive patients infected hepatitis C virus genotype 4: a randomized trial

Author(s): Benhamou Y, Moussalli J, Ratziu V, Lebray P, De Backer K, et al.

Socioeconomic status in HCV infected patients - risk and prognosis

Author(s): Omland LH, Osler M, Jepsen P, Krarup H, Weis N, et al.

Peginterferon alfa-2b plus ribavirin for the treatment of chronic hepatitis C genotype 4

Author(s): Hasan F, Asker H, Al-Khaldi J, Siddique I, Al-Ajmi M, et al.

Response to pegylated interferon alfa-2a and ribavirin in chronic hepatitis C genotype 4

Author(s): El Makhzangy H, Esmat G, Said M, Elraziky M, Shouman S, et al.

Sofosbuvir for previously untreated chronic hepatitis C infection

Author(s): Lawitz E, Mangia A Wyles D, Rodriguez-Torres M, Hassanein T, et al.

Efficacy and safety of sofosbuvir-based triple therapy in hepatitis C genotype 4 infection

Author(s): Wehmeyer MH, Jordan S, Lüth S, Hartl J, Stoehr A, et al.

Daclatasvir plus peginterferonalfa and ribavirin for treatment-naive chronic hepatitis C genotype 1 or 4 infection: a randomised study

Author(s): Hézode C, Hirschfield GM, Ghesquiere W, Sievert W, Rodriguez-Torres M, et al.

Daclatasvir and asunaprevir plus peginterferonalfa and ribavirin in HCV genotype 1 or 4 non-responders

Author(s): Jensen D, Sherman KE, Hézode C, Pol S, Zeuzem S, et al.

Hepatitis C virus treatment in the real world: optimising treatment and access to therapies

Author(s): Zoulim F, Liang TJ, Gerbes AL Aghemo A4, Deuffic-Burban S5, et al.

Sofosbuvir plus ribavirin for treating Egyptian patients with hepatitis C genotype 4

Author(s): Doss W, Shiha G, Hassany M, Soliman R, Fouad R, et al.

Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection

Author(s): Sulkowski MS, Gardiner DF, Rodriguez-Torres M, Reddy KR, Hassanein T, et al.

Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection

Author(s): Afdhal N, Zeuzem S, Kwo P, Chojkier M, Gitlin N, et al.