Back to Browse Journals » Therapeutics and Clinical Risk Management » Volume 4 » Issue 4

Pegylated interferon 2a and 2b in combination with ribavirin for the treatment of chronic hepatitis C in HIV infected patients

Authors Ravinder Dhillon, Simona Rossi, Steven K Herrine

Published 8 August 2008 Volume 2008:4(4) Pages 789—796

DOI http://dx.doi.org/10.2147/TCRM.S2093

Ravinder Dhillon, Simona Rossi, Steven K Herrine

Department of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA, USA

Abstract: Coinfection with hepatitis C virus (HCV) and HIV is an increasingly recognized clinical dilemma, particularly since the advent of highly active antiretroviral therapy. Several studies of this population have demonstrated both more rapid progression of liver disease and poorer overall prognosis compared to HCV monoinfected patients. Consensus guidelines, based primarily on the results of 4 major randomized trials, recommend treatment with peginterferon and ribavirin for 48 weeks in coinfected patients. However, this current standard of care is associated with lower response rates to therapy than those seen in monoinfected patients. Important predictors of response include HCV genotype, pretreatment HCV RNA level, and presence of rapid virologic response (RVR) and early virologic response (EVR). Use of weight-based ribavirin dosing appears to be safe and enhances the likelihood of sustained virologic response (SVR). Adverse effects most commonly encountered are anemia and weight loss. Mitochondrial toxicity can occur in the setting of concomitant nucleoside reverse transcriptase inhibitor use, especially didanosine, abacavir, and zidovudine, and these should be discontinued before initiation of ribavirin therapy. Discontinuation of therapy should be considered in patients failing to demonstrate EVR, though ongoing trials are investigating a potential role for maintenance therapy in these patients. Peginterferon combined with weight-based ribavirin is appropriate and safe for treatment of HCV in HIV – HCV coinfected patients. This review summarizes the data supporting these recommendations.

Keywords: hepatitis C, human immunodeficiency virus, peginterferon, ribavirin

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Readers of this article also read:

Multi-targeted approach in the treatment of thyroid cancer

Scott N Pinchot, Rebecca S Sippel, Herbert Chen

Therapeutics and Clinical Risk Management 2008, 4:935-947

Published Date: 10 October 2008

Posaconazole in the management of refractory invasive fungal infections

Stefan Langner, Philipp B Staber, Peter Neumeister

Therapeutics and Clinical Risk Management 2008, 4:747-757

Published Date: 8 August 2008

The treatment of chronic hepatitis B: Focus on adefovir-like antivirals

Hans Ludger Tillmann

Therapeutics and Clinical Risk Management 2008, 4:797-802

Published Date: 8 August 2008

A systematic approach of tracking and reporting medication errors at a tertiary care university hospital, Karachi, Pakistan

Khurshid Khowaja, Rozmin Nizar, Rashida J Merchant, Jacqueline Dias, Irma Bustamante-Gavino, Amina Malik

Therapeutics and Clinical Risk Management 2008, 4:673-679

Published Date: 8 August 2008

Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

Benjamin E Levitzky, John J Vargo

Therapeutics and Clinical Risk Management 2008, 4:733-738

Published Date: 8 August 2008

Combating HIV resistance – focus on darunavir

Cécile L Tremblay

Therapeutics and Clinical Risk Management 2008, 4:759-765

Published Date: 8 August 2008

Sevelamer carbonate in the treatment of hyperphosphatemia in patients with chronic kidney disease on hemodialysis

Vincenzo Savica, Domenico Santoro, Paolo Monardo, Agostino Mallamace, Guido Bellinghieri

Therapeutics and Clinical Risk Management 2008, 4:821-826

Published Date: 8 August 2008

A 41-year-old man with polyarthritis and severe autonomic neuropathy

Matthew E Bourcier, Aaron I Vinik

Therapeutics and Clinical Risk Management 2008, 4:837-842

Published Date: 8 August 2008