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Hepatitis C biral kinetics during treatment with weekly versus twice weekly peg IFN-alpha-2a in HIV/HCV co-infected patients
Presented by Michael Polis, United States.
Polis M.1, Sachau W.1, O'Shea M.1, Rehm C.1, Koratich C.1, Masur H.2, Kottilil S.1
1NIH/NIAID/LIR, Bethesda, United States, 2CCMD/CC/NIH, Bethesda, United States
Objectives: HCV/HIV co-infected patients have only modest rates of sustained virologic responses (SVR) when compared to HCV monoinfected patients. We compared the virologic response to twice-weekly peginterferon-alpha-2a (for 4 weeks, followed by weekly dosing) with weekly peginterferon-alpha 2a plus ribavirin among HIV/HCV co-infected subjects.
Methods: Eleven HIV/HCV co-infected patients were treated with standard weekly PEG-IFN (180ug sc qwk) and 11 received twice weekly Peg-IFN (180ug sc twice-weekly) for 4 weeks followed by weekly doses for a total of 48 weeks. Both groups received RBV (1-1.2g daily) for 48 weeks. HCV, HIV VL, immunologic and biochemical parameters were performed prior to and at frequently during treatment.
Results: Eight of 11 (72%) subjects in the double-dose arm achieved more than a log reduction in the HCV RNA level by day seven compared with one of 11 (9%) subjects in the single dose arm (p=0.02). The percentage of subjects achieving <615 IU/mL of HCV RNA by weeks 1, 4 and 8, and 12 on the double-dose arm was greater than the single-dose arm (27%, 54%, 63% and 72% vs. 0%, 27%, 36% and 45% respectively). Of those completing treatment, subjects on the double-dose arm had higher end-of-treatment responses (45% vs 20%) and SVR (40% vs 18%) compared with subjects receiving standard therapy. The adverse events were similar in both arms
Conclusions: Twice-weekly peginterferon-alpha-2a is associated with better early virologic response with similar safety profiles when compared with standard therapy. Our results, when confirmed in larger clinical trials, may provide a novel therapeutic approach to improve SVR among HIV/HCV co-infected patients.
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