Current treatment for chronic hepatitis C virus/HIV-infected individuals: the role of pegylated interferon-alpha and ribavirin

被引:19
作者
Bhagani, Sanjay [1 ,2 ]
机构
[1] UCL, Royal Free Hosp, Dept Infect Dis & HIV Med, London, England
[2] UCL, Res Dept Infect, London, England
关键词
HIV/hepatitis C co-infection; pegylated interferon-alpha; ribavirin; treatment; SUSTAINED VIROLOGICAL RESPONSE; HIV/HCV-COINFECTED PATIENTS; HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; WEIGHT-BASED RIBAVIRIN; 40KD PLUS RIBAVIRIN; CD4 CELL COUNT; HCV THERAPY; PEGINTERFERON ALPHA-2A; RISK-FACTORS;
D O I
10.1097/COH.0b013e32834bd257
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose of review Liver disease is an important cause of morbidity and mortality in the era of combination antiretroviral therapy in HIV/hepatitis C virus (HCV) co-infected patients. This review highlights the role of pegylated interferon-alpha (peg-IFN) and ribavirin (RBV) therapy and examines factors associated with response and strategies to maximize responses. Recent findings HCV viral clearance is lower in HIV co-infected patients than in HCV mono-infected patients. However, in patients who attain sustained response there is clinical benefit in terms of liver disease associated morbidity and mortality and treatment is costeffective. Predictors of response appear similar, although there are a number of modifiable patient-associated and HIV-associated factors that could be addressed. Moreover, the use of weight-based RBV and treatment length guided by early viral responses improve response rate. Avoidance of drug-drug interactions and use of haematopoietic growth factors reduce adverse events and dose reductions and ultimately increase response rates. Very early prediction of treatment futility is promising. Induction dosing strategies have not yielded positive results, though twice weekly peg-IFN-alpha-2a induction therapy merits further investigation. Summary Peg-IFN/RBV therapy plays an important role in the management of HCV in HIV-infected patients. Efforts to maximize response to current therapy need to continue while we await new therapies.
引用
收藏
页码:483 / 490
页数:8
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