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Peginterferon plus Ribavirin for HIV-infected Patients with Treatment-Naïve Acute or Chronic HCV Infection in Taiwan: A Prospective Cohort Study.

Liu CH, Sheng WH, Sun HY, Hsieh SM, Lo YC, Liu CJ, Su TH, Yang HC, Liu WC, Chen PJ, Chen DS, Hung CC, Kao JH - Sci Rep (2015)

Bottom Line: Data are limited on the effectiveness and safety of peginterferon plus ribavirin in HIV-infected Asian patients with acute or chronic HCV infection.The primary endpoint was sustained virologic response (SVR), defined as undetectable HCV RNA 24 weeks off-therapy.In conclusion, the SVR rates of peginterferon plus ribavirin for 24 weeks and for response-guided 12-72 weeks are satisfactory in HIV-infected Taiwanese patients with acute and chronic HCV infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

ABSTRACT
Data are limited on the effectiveness and safety of peginterferon plus ribavirin in HIV-infected Asian patients with acute or chronic HCV infection. HIV-infected Taiwanese patients with acute HCV infection received peginterferon plus weight-based ribavirin for 24 weeks (n = 24), and those with chronic HCV genotype 1 or 6 (HCV-1/6) and HCV genotype 2 or 3 (HCV-2/3) infection received response-guided therapy for 12-72 and 24-48 weeks, respectively (n = 92). The primary endpoint was sustained virologic response (SVR), defined as undetectable HCV RNA 24 weeks off-therapy. The SVR rates were 83% and 72% in patients with acute and chronic HCV infection (p = 0.30), and 68% and 72% in patients with chronic HCV-1/6 and HCV-2/3 infection (p = 0.48), respectively. While no factors predicted SVR in acute HCV and chronic HCV-2/3 infection, age (odds ratio [OR] per 1-year increase: 0.88, 95% confidence interval [CI]: 0.78-0.99, p = 0.04), HCV RNA (OR per 1-log10 increase: 0.18, 95% CI: 0.03-0.98, p = 0.03), IL28B genotype (OR: 5.52, 95% CI: 1.55-12.2, p = 0.02), and RVR (OR: 9.62, 95% CI: 3.89-15.3, p = 0.007) predicted SVR in chronic HCV-1/6 infection. In conclusion, the SVR rates of peginterferon plus ribavirin for 24 weeks and for response-guided 12-72 weeks are satisfactory in HIV-infected Taiwanese patients with acute and chronic HCV infection.

No MeSH data available.


Related in: MedlinePlus

Treatment algorithms in HIV-infected patients with acute or chronic HCV infection by peginterferon alfa-2a plus weight-based ribavirin*.HIV, human immunodeficiency virus; HCV, hepatitis C virus; RVR, rapid virologic response; Wk-8R, week 8 virologic response; EVR, early virologic response. *Peginterferon alfa-2a at a dosage of 180 μg/week; ribavirin at a dosage of 1,000–1,200 mg/day (cut-off body weight, 75 kg).
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f2: Treatment algorithms in HIV-infected patients with acute or chronic HCV infection by peginterferon alfa-2a plus weight-based ribavirin*.HIV, human immunodeficiency virus; HCV, hepatitis C virus; RVR, rapid virologic response; Wk-8R, week 8 virologic response; EVR, early virologic response. *Peginterferon alfa-2a at a dosage of 180 μg/week; ribavirin at a dosage of 1,000–1,200 mg/day (cut-off body weight, 75 kg).

Mentions: All treated patients received peginterferon alfa-2a 180 μg/week (Pegasys, Hoffman-LaRoche, Basel, Switzerland) plus weight-based ribavirin (Copegus, Hoffman-LaRoche, Basel, Switzerland; 1,000 mg/day for patients weighted <75 kg and 1,200 mg/day for patients weighted ≥75 kg). Because patients with acute HCV infection may spontaneously clear viremia, they received follow-up for 12 weeks before the decision to initiate treatment. If patients had persistent viremia for ≥12 weeks, they received 24 weeks of treatment. Patients with chronic HCV-1/6 infection were treated for 24 weeks if they had low baseline viral load and achieved RVR (defined as undetectable serum HCV RNA at week 4 of treatment); 48 weeks if they had high baseline viral load and achieved RVR, or if they failed to achieve RVR but achieved week 8 virologic response (Wk-8R, defined as undetectable serum HCV RNA at week 8 of treatment in the absence of RVR); 72 weeks of they failed to achieved Wk-8R but achieved EVR (defined as ≥2 log10 viral load reduction from baseline to week 12 of treatment)(Arms A-D)2042. Patients with chronic HCV-2/3 infection, they were treated for 24 weeks of they achieved RVR; 48 weeks if they failed to achieve RVR (Arms F and G)43. All patients received 12 weeks of treatment if they failed to achieve EVR (Arms E and H)(Fig. 2). Patients with mixed HCV genotypes 1/2 and 1/6a or with HCV genotypes 2/3 infections received the same response-guided therapies as proposed for those with HCV-1/6 or HCV-2/3monoinfection. For TEAEs, the dosages of peginterferon and ribavirin were adjusted according to package insert’s recommendations.


Peginterferon plus Ribavirin for HIV-infected Patients with Treatment-Naïve Acute or Chronic HCV Infection in Taiwan: A Prospective Cohort Study.

Liu CH, Sheng WH, Sun HY, Hsieh SM, Lo YC, Liu CJ, Su TH, Yang HC, Liu WC, Chen PJ, Chen DS, Hung CC, Kao JH - Sci Rep (2015)

Treatment algorithms in HIV-infected patients with acute or chronic HCV infection by peginterferon alfa-2a plus weight-based ribavirin*.HIV, human immunodeficiency virus; HCV, hepatitis C virus; RVR, rapid virologic response; Wk-8R, week 8 virologic response; EVR, early virologic response. *Peginterferon alfa-2a at a dosage of 180 μg/week; ribavirin at a dosage of 1,000–1,200 mg/day (cut-off body weight, 75 kg).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663763&req=5

f2: Treatment algorithms in HIV-infected patients with acute or chronic HCV infection by peginterferon alfa-2a plus weight-based ribavirin*.HIV, human immunodeficiency virus; HCV, hepatitis C virus; RVR, rapid virologic response; Wk-8R, week 8 virologic response; EVR, early virologic response. *Peginterferon alfa-2a at a dosage of 180 μg/week; ribavirin at a dosage of 1,000–1,200 mg/day (cut-off body weight, 75 kg).
Mentions: All treated patients received peginterferon alfa-2a 180 μg/week (Pegasys, Hoffman-LaRoche, Basel, Switzerland) plus weight-based ribavirin (Copegus, Hoffman-LaRoche, Basel, Switzerland; 1,000 mg/day for patients weighted <75 kg and 1,200 mg/day for patients weighted ≥75 kg). Because patients with acute HCV infection may spontaneously clear viremia, they received follow-up for 12 weeks before the decision to initiate treatment. If patients had persistent viremia for ≥12 weeks, they received 24 weeks of treatment. Patients with chronic HCV-1/6 infection were treated for 24 weeks if they had low baseline viral load and achieved RVR (defined as undetectable serum HCV RNA at week 4 of treatment); 48 weeks if they had high baseline viral load and achieved RVR, or if they failed to achieve RVR but achieved week 8 virologic response (Wk-8R, defined as undetectable serum HCV RNA at week 8 of treatment in the absence of RVR); 72 weeks of they failed to achieved Wk-8R but achieved EVR (defined as ≥2 log10 viral load reduction from baseline to week 12 of treatment)(Arms A-D)2042. Patients with chronic HCV-2/3 infection, they were treated for 24 weeks of they achieved RVR; 48 weeks if they failed to achieve RVR (Arms F and G)43. All patients received 12 weeks of treatment if they failed to achieve EVR (Arms E and H)(Fig. 2). Patients with mixed HCV genotypes 1/2 and 1/6a or with HCV genotypes 2/3 infections received the same response-guided therapies as proposed for those with HCV-1/6 or HCV-2/3monoinfection. For TEAEs, the dosages of peginterferon and ribavirin were adjusted according to package insert’s recommendations.

Bottom Line: Data are limited on the effectiveness and safety of peginterferon plus ribavirin in HIV-infected Asian patients with acute or chronic HCV infection.The primary endpoint was sustained virologic response (SVR), defined as undetectable HCV RNA 24 weeks off-therapy.In conclusion, the SVR rates of peginterferon plus ribavirin for 24 weeks and for response-guided 12-72 weeks are satisfactory in HIV-infected Taiwanese patients with acute and chronic HCV infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

ABSTRACT
Data are limited on the effectiveness and safety of peginterferon plus ribavirin in HIV-infected Asian patients with acute or chronic HCV infection. HIV-infected Taiwanese patients with acute HCV infection received peginterferon plus weight-based ribavirin for 24 weeks (n = 24), and those with chronic HCV genotype 1 or 6 (HCV-1/6) and HCV genotype 2 or 3 (HCV-2/3) infection received response-guided therapy for 12-72 and 24-48 weeks, respectively (n = 92). The primary endpoint was sustained virologic response (SVR), defined as undetectable HCV RNA 24 weeks off-therapy. The SVR rates were 83% and 72% in patients with acute and chronic HCV infection (p = 0.30), and 68% and 72% in patients with chronic HCV-1/6 and HCV-2/3 infection (p = 0.48), respectively. While no factors predicted SVR in acute HCV and chronic HCV-2/3 infection, age (odds ratio [OR] per 1-year increase: 0.88, 95% confidence interval [CI]: 0.78-0.99, p = 0.04), HCV RNA (OR per 1-log10 increase: 0.18, 95% CI: 0.03-0.98, p = 0.03), IL28B genotype (OR: 5.52, 95% CI: 1.55-12.2, p = 0.02), and RVR (OR: 9.62, 95% CI: 3.89-15.3, p = 0.007) predicted SVR in chronic HCV-1/6 infection. In conclusion, the SVR rates of peginterferon plus ribavirin for 24 weeks and for response-guided 12-72 weeks are satisfactory in HIV-infected Taiwanese patients with acute and chronic HCV infection.

No MeSH data available.


Related in: MedlinePlus