Tratamiento con interferón y Ribavirina de la hepatitis crónica por virus C en pacientes con infección por VIH

Abstract

Background: The rapid progression of chronic hepatitis C (CHC) in HIV-infected patients is now the most important cause of morbidity, mortality and hospital admissions. In order to avoid this evolution, the treatment of CHC is a major challenge in these patients. Patients and method: The aim of this study is to evaluate the safety and efficacy of treatment of CHC in HIV-infected patients with subcutaneous IFN (3 MU 3 times a week) plus Ribavirin (RBV) administered per os depending on their body weight, for 24 weeks for genotype 2 or 3 and 48 weeks for genotype 1 or 4. All the patients have a CD4 count over 150 cells/μl and HIV viral load < 5,000 copies/ml, with or without antiretroviral treatment. We defined sustained response as RNA-VHC below level of detection 24 weeks after the end of treatment. Results: We included 28 patients in the study, with median age of 36,6 y.o. 81% of the patients were on antiretroviral treatment, with AZT in 60% of them. Genotype distribution was HCV-1 in 50%, HCV-3 in 35,7%, HCV-4 in 10,7% and HCV-2 in 3%. Liver biopsy was performed in all the patients. Adverse events leading to treatment discontinuation occurred in 5 patients (17,8%). The overall sustained response rate in the intent-to-treat analysis was 25,8% (50% for genotype 3 and 14% for genotype 1). Conclusion: This therapy provides cure in a rate significantly lower than that seen in HCV-monoinfected individuals, with a similar safety. The modern formulations of IFN (pegylated) will provide new expectatives in this group of patients.