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:

Evaluation of extended and continuous use oral contraceptives

Kristen Page Wright, Julia V Johnson

Therapeutics and Clinical Risk Management 2008, 4:905-911

Published Date: 10 October 2008

Beclomethasone/formoterol fixed combination for the management of asthma: patient considerations

Gabriele Nicolini, Nicola Scichilone, Andrea Bizzi, Alberto Papi, Leonardo M Fabbri

Therapeutics and Clinical Risk Management 2008, 4:855-864

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

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

Clinical development of new prophylactic antimalarial drugs after the 5th Amendment to the Declaration of Helsinki

Geoffrey S Dow, Alan J Magill, Colin Ohrt

Therapeutics and Clinical Risk Management 2008, 4:803-819

Published Date: 8 August 2008

Early ischemic CT changes before thrombolysis: The influence of age and diabetes mellitus

Lars Thomassen, Ulrike Waje-Andreassen, Halvor Naess

Therapeutics and Clinical Risk Management 2008, 4:699-703

Published Date: 8 August 2008

Double-blind, randomized trial comparing efficacy and safety of continuing olanzapine versus switching to quetiapine in overweight or obese patients with schizophrenia or schizoaffective disorder

Walter Deberdt, Ilya Lipkovich, Alexandra N Heinloth, Lin Liu, Sara Kollack-Walker, et al

Therapeutics and Clinical Risk Management 2008, 4:713-720

Published Date: 8 August 2008