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Treatment of chronic hepatitis C in patients with human immunodeficiency virus (HIV) with weekly peginterferon alpha-2b plus ribavirin: a multi-centred Belgian study

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Abstract
Background and study aims : In Belgium, 10-15% of patients infected with the human immunodeficiency virus (HIV) are coinfected with hepatitis C virus (HCV). Because of increased incidence of antiretroviral drug-related hepatotoxicity and more rapid clinical evolution towards end-stage liver disease, treatment of chronic hepatitis C becomes a priority. We report the results or a multi-centred Belgian study evaluating efficacy and safety of peginterferon alpha-2b plus ribavirin in HIV-HCV co-infected patients without AIDS and without decompensated liver disease. Patients and methods : Forty-one patients, all genotypes, were screened to participate. Eventually 37 received treatment with peginterferon alpha-2b (1.5 mu g/kg/week) plus daily weight-based ribavirin for 52 weeks. About one third of the patients were genotypes 1, 2/3, and genotype 4, most of the latter being of Central African origin. About 56% of the patients had severe fibrosis (Metavir score >= F3). Results : Sustained viral response (SVR) at 24 weeks of follow-up was observed in 10/37 (27%) of patients. SVR was higher in genotype 2/3 compared to genotype 1/4 (46.7% versus 13.6%; p = 0.06) and in low (F0-F1) versus high (F2-F4) grade fibrosis (p = 0.06). Treatment was withdrawn for side effects in 11/37 patients (30%). One Child A cirrhosis patient at the start of therapy died 7 months after treatment withdrawal as a result of severe haemolytic anaemia. Conclusions : It can be concluded that weight-based peginterferon alpha-2b plus ribavirin can be successful in selected HIV-HCV co-infected patients. Caution should be applied in patients with advanced liver disease. (Acta gastroenterol. belg., 2009, 72, 389-393).
Keywords
PEGYLATED INTERFERON-ALPHA-2B, INFECTED PATIENTS, COINFECTED PATIENTS, HCV/HIV-COINFECTION, THERAPY, TRIAL, GENOTYPE-4

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Chicago
Michielsen, P, E Bottieau, Hans Van Vlierberghe, E Van Marck, E Vandemaele, M Denys, JP Brasseur, M Popan, and Belgian Assoc Study Liver. 2009. “Treatment of Chronic Hepatitis C in Patients with Human Immunodeficiency Virus (HIV) with Weekly Peginterferon Alpha-2b Plus Ribavirin: a Multi-centred Belgian Study.” Acta Gastro-enterologica Belgica 72 (4): 389–393.
APA
Michielsen, P., Bottieau, E., Van Vlierberghe, H., Van Marck, E., Vandemaele, E., Denys, M., Brasseur, J., et al. (2009). Treatment of chronic hepatitis C in patients with human immunodeficiency virus (HIV) with weekly peginterferon alpha-2b plus ribavirin: a multi-centred Belgian study. ACTA GASTRO-ENTEROLOGICA BELGICA, 72(4), 389–393.
Vancouver
1.
Michielsen P, Bottieau E, Van Vlierberghe H, Van Marck E, Vandemaele E, Denys M, et al. Treatment of chronic hepatitis C in patients with human immunodeficiency virus (HIV) with weekly peginterferon alpha-2b plus ribavirin: a multi-centred Belgian study. ACTA GASTRO-ENTEROLOGICA BELGICA. 2009;72(4):389–93.
MLA
Michielsen, P, E Bottieau, Hans Van Vlierberghe, et al. “Treatment of Chronic Hepatitis C in Patients with Human Immunodeficiency Virus (HIV) with Weekly Peginterferon Alpha-2b Plus Ribavirin: a Multi-centred Belgian Study.” ACTA GASTRO-ENTEROLOGICA BELGICA 72.4 (2009): 389–393. Print.
@article{1003108,
  abstract     = {Background and study aims : In Belgium, 10-15\% of patients infected with the human immunodeficiency virus (HIV) are coinfected with hepatitis C virus (HCV). Because of increased incidence of antiretroviral drug-related hepatotoxicity and more rapid clinical evolution towards end-stage liver disease, treatment of chronic hepatitis C becomes a priority. We report the results or a multi-centred Belgian study evaluating efficacy and safety of peginterferon alpha-2b plus ribavirin in HIV-HCV co-infected patients without AIDS and without decompensated liver disease.
Patients and methods : Forty-one patients, all genotypes, were screened to participate. Eventually 37 received treatment with peginterferon alpha-2b (1.5 mu g/kg/week) plus daily weight-based ribavirin for 52 weeks. About one third of the patients were genotypes 1, 2/3, and genotype 4, most of the latter being of Central African origin. About 56\% of the patients had severe fibrosis (Metavir score {\textrangle}= F3).
Results : Sustained viral response (SVR) at 24 weeks of follow-up was observed in 10/37 (27\%) of patients. SVR was higher in genotype 2/3 compared to genotype 1/4 (46.7\% versus 13.6\%; p = 0.06) and in low (F0-F1) versus high (F2-F4) grade fibrosis (p = 0.06). Treatment was withdrawn for side effects in 11/37 patients (30\%). One Child A cirrhosis patient at the start of therapy died 7 months after treatment withdrawal as a result of severe haemolytic anaemia.
Conclusions : It can be concluded that weight-based peginterferon alpha-2b plus ribavirin can be successful in selected HIV-HCV co-infected patients. Caution should be applied in patients with advanced liver disease. (Acta gastroenterol. belg., 2009, 72, 389-393).},
  author       = {Michielsen, P and Bottieau, E and Van Vlierberghe, Hans and Van Marck, E and Vandemaele, E and Denys, M and Brasseur, JP and Popan, M and Assoc Study Liver, Belgian},
  issn         = {0001-5644},
  journal      = {ACTA GASTRO-ENTEROLOGICA BELGICA},
  keyword      = {PEGYLATED INTERFERON-ALPHA-2B,INFECTED PATIENTS,COINFECTED PATIENTS,HCV/HIV-COINFECTION,THERAPY,TRIAL,GENOTYPE-4},
  language     = {eng},
  number       = {4},
  pages        = {389--393},
  title        = {Treatment of chronic hepatitis C in patients with human immunodeficiency virus (HIV) with weekly peginterferon alpha-2b plus ribavirin: a multi-centred Belgian study},
  volume       = {72},
  year         = {2009},
}

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