Differences in HCV viral decline between low and standard-dose pegylated-interferon-alpha-2a with ribavirin in HIV/HCV genotype 3 patients

PLoS One. 2012;7(11):e48959. doi: 10.1371/journal.pone.0048959. Epub 2012 Nov 8.

Abstract

Background: The aim of the study was to analyze the different impact of standard and low-dose Peg-IFN-α2a/RBV therapies on HCV viral decline in HIV/HCV genotype 3 co-infected patients during the first weeks of treatment.

Methods: Plasma HCV viral decline was analyzed between baseline and weeks 1, 2 and 4 in two groups of treatment-naïve HCV genotype 3 patients with HIV co-infection. The Standard Dose Group (SDG) included patients who received Peg-IFN at 180 µg/per week with a weight-adjusted dose of ribavirin; Low-Dose Group (LDG) patients received Peg-IFN at 135 µg/per week with 800 mg/day ribavirin. The effect of IL28B genotype on HCV viral decline was evaluated in both groups. HCV viral decline was analyzed using a multivariate linear regression model.

Results: One hundred and six patients were included: 48 patients in the SDG and 58 in the LDG. HCV viral decline for patients in the LDG was less than for those in the SDG (week 1:1.72±0.74 log(10) IU/mL versus 1.78±0.67 log(10) IU/mL, p = 0.827; week 2:2.3±0.89 log(10) IU/mL versus 3.01±1.02 log(10) IU/mL, p = 0.013; week 4:3.52±1.2 log(10) IU/mL versus 4.09±1.1 log(10) IU/mL, p = 0.005). The linear regression model identified the Peg-IFN/RBV dose as an independent factor for HCV viral decline at week 4.

Conclusions: Our results showed that HCV viral decline was less for patients in the low-dose group compared to those receiving the standard dose. Until a randomized clinical trial is conducted, clinicians should be cautious about using lower doses of Peg-IFN/RBV in HIV/HCV genotype 3 co-infected patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Coinfection / drug therapy
  • Coinfection / genetics
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination / methods
  • Female
  • Genotype
  • HIV / genetics
  • HIV / growth & development*
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / genetics
  • HIV Infections / virology
  • Hepacivirus / genetics
  • Hepacivirus / growth & development*
  • Hepatitis C / blood
  • Hepatitis C / drug therapy*
  • Hepatitis C / genetics
  • Hepatitis C / virology
  • Humans
  • Interferon-alpha / administration & dosage*
  • Male
  • Polyethylene Glycols / administration & dosage*
  • Prospective Studies
  • Recombinant Proteins / administration & dosage
  • Ribavirin / administration & dosage*
  • Treatment Outcome
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a

Grants and funding

This work was partly supported by grants from the Fundación Progreso y Salud, Consejería de Salud de la Junta de Andalucía (grants for health research projects: refs. 0036/2010, PI-0247-2010 and PI-0208 and 0124/2008) and the Spanish Health Ministry (ISCIII-RETIC RD06/006, and projects PI10/0164 and PI10/01232). AR is the recipient of a research extension grant from the Fundación Progreso y Salud, Consejería de Salud de la Junta de Andalucía (Reference AI-0011-2010); JAP is the recipient of extension grant from the Instituto de Salud Carlos III (grant number Programa-I3SNS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.