Document Detail


Role of weight-based ribavirin dosing and extended duration of therapy in chronic hepatitis C in HIV-infected patients: the PRESCO trial.
MedLine Citation:
PMID:  17725413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The response to pegylated interferon (pegIFN) plus ribavirin (RBV) as treatment of chronic hepatitis C virus (HCV) infection is lower in HIV-coinfected than in HCV-monoinfected patients and could be due to suboptimal RBV dosing and/or insufficient duration of therapy in prior trials. In a prospective, multicenter, open, comparative trial, HCV/HIV-coinfected patients received pegIFN plus weight-based RBV for 48 or 72 weeks (HCV genotypes 1 and 4) and 24 or 48 weeks (HCV genotypes 2 and 3). Use of didanosine was not allowed. Out of 389 patients included in the trial, 61% were infected by HCV-1/4 and 67% had serum HCV-RNA >500,000 IU/ml. Sustained virological response (SVR) was achieved by 49.6%, significantly higher in HCV-2/3 than HCV-1/4 (72.4% vs. 35%; p < 0.0001). A high drop-out rate in the longer treatment arms precluded obtaining definitive conclusions about the efficacy of prolonging therapy. Premature treatment discontinuations due to serious adverse events occurred in 8.2%. Infection with HCV-2/3, lower baseline HCV-RNA, and negative HCV-RNA at week 12 were all independent predictors of SVR in the multivariate analysis. The use of RBV 1000-1200 mg/day plus pegIFN is relatively safe and provides SVR in nearly half of coinfected patients, twice as high in HCV-2/3 than HCV-1/4.
Authors:
Marina Núñez; Celia Miralles; Miguel Angel Berdún; Elena Losada; Koldo Aguirrebengoa; Antonio Ocampo; Piedad Arazo; Manuel Cervantes; Ignacio de Los Santos; Isabel San Joaquín; Santiago Echeverría; María José Galindo; Victor Asensi; Pablo Barreiro; Julio Sola; Juan José Hernandez-Burruezo; Josep Maria Guardiola; Miriam Romero; Javier García-Samaniego; Vincent Soriano;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS research and human retroviruses     Volume:  23     ISSN:  0889-2229     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-29     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  972-82     Citation Subset:  IM; X    
Affiliation:
Department of Infectious Diseases, Hospital Carlos III, Calle Sinesio Delgado 10, Madrid 28029, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / therapeutic use*
CD4 Lymphocyte Count
Female
HIV*
HIV Infections / complications*,  drug therapy,  virology
Hepacivirus / drug effects
Hepatitis C, Chronic / complications,  drug therapy*,  virology
Humans
Interferon Alfa-2a / therapeutic use*
Interferon Alfa-2b / therapeutic use
Male
Polyethylene Glycols / therapeutic use*
Prospective Studies
Ribavirin / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Polyethylene Glycols; 0/peginterferon alfa-2a; 0/peginterferon alfa-2b; 36791-04-5/Ribavirin; 76543-88-9/Interferon Alfa-2a; 99210-65-8/Interferon Alfa-2b

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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