Document Detail


Successful HCV eradication and inhibition of HIV replication by intravenous silibinin in an HIV-HCV coinfected patient.
MedLine Citation:
PMID:  20709593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The efficacy of antiviral therapy with pegylated interferon (PEGIFN) plus ribavirin (RBV) in patients with HIV and hepatitis C virus (HCV) coinfection is limited. Intravenous silibinin (ivSIL), a milk thistle extract with proven antiviral effects represents a novel therapeutic strategy for virological nonresponders.
METHODS: We report a case of an HIV-HCV coinfected patient, who has not responded to a prior course of PEGIFN-α2a (180 μg/week/s.c.) and RBV (1000 mg/day/p.o.). Testing for IL-28β small nucleotid polymorphism revealed the nonfavourable genotype T/T. Antiretroviral therapy was not prescribed because the patients presented with well-preserved CD4+ cell counts and low HIV-RNA levels. She received retreatment with ivSIL for two weeks followed by PEGIFN/RBV combination therapy starting at week 1.
RESULTS: After 2 weeks of ivSIL therapy both HCV-RNA and HIV-RNA become undetectable. On ivSIL monotherapy we noticed a trend towards an increase of CD4+ cell counts and a decrease of HIV-RNA. After 16 weeks PEGIFN+RBV was discontinued due to patients wish because of adverse events. HCV-RNA was still negative 24 weeks after cessation of therapy, while HIV-RNA returned to baseline levels.
CONCLUSION: ivSIL may represent a potential treatment option for retreatment of HIV-HCV coinfected patients nonresponding to PEGIFN+RBV combination therapy. Further investigations on the possible beneficial effects of ivSIL on CD4+ cell counts and HIV-RNA levels are necessary.
Authors:
B A Payer; T Reiberger; K Rutter; S Beinhardt; A F Staettermayer; M Peck-Radosavljevic; P Ferenci
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-14
Journal Detail:
Title:  Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology     Volume:  49     ISSN:  1873-5967     ISO Abbreviation:  J. Clin. Virol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815671     Medline TA:  J Clin Virol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  131-3     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Waehringer Guertel 18-20, A1090 Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / administration & dosage*
CD4 Lymphocyte Count
Female
HIV / isolation & purification
HIV Infections / complications*,  drug therapy*
Hepacivirus / isolation & purification
Hepatitis C, Chronic / complications*,  drug therapy*
Humans
Interferon Alfa-2a / administration & dosage
Polyethylene Glycols / administration & dosage
RNA, Viral / blood
Ribavirin / administration & dosage
Silymarin / administration & dosage*
Treatment Outcome
Viral Load
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Polyethylene Glycols; 0/RNA, Viral; 0/Silymarin; 0/peginterferon alfa-2a; 22888-70-6/silybin; 36791-04-5/Ribavirin; 76543-88-9/Interferon Alfa-2a

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


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