51647
document
Effect of an induction period of pegylated interferon-α2a and ribavirin on early virological response in HIV-HCV-coinfected patients : results from the CORAL-2 study . BACKGROUND It is uncertain whether a 4-week induction period of pegylated interferon and ribavirin increases early virological response ( EVR ) in HIV-HCV-coinfected patients . METHODS HIV and HCV genotype 1- and 4-coinfected subjects were randomized to receive pegylated interferon-α2a 270 μg/week plus ribavirin 1,600 mg daily and epoetin-β for 4 weeks , followed by pegylated interferon-α2a at standard dosages plus weight-based ribavirin ( WBR ) dosage for 8 weeks ( induction arm [ IA ] ) , or pegylated interferon-α2a plus WBR for 12 weeks ( standard therapy arm [ SA ] ) . HCV RNA was determined at weeks 0 , 1 , 2 , 3 , 4 , 8 and 12 . Ribavirin plasma trough concentrations were determined at weeks 4 ( RBV-C ( 4 ) ) and 12 ( RBV-C ( 12 ) ) . RESULTS A total of 67 patients were included ; 33 in the SA and 34 in the IA . Overall , 25 % received nucleoside reverse transcriptase inhibitor ( NRTI ) -sparing regimens . More patients achieved an HCV RNA decrease ≥1 log ( 10 ) at week 4 in the IA than in the SA ( 62 % versus 38 % ; P=0.017 ) , but EVR rates were similar in the two groups ( 74 % versus 59 % in the IA and SA , respectively ; P=0.15 ) . Independent predictors of faster HCV RNA decrease at 12 weeks were higher RBV-C ( 4 ) and younger age . RBV-C ( 4 ) were higher in patients allocated in the IA and in those receiving NRTIs ( P=0.039 ) . CONCLUSIONS A 4-week induction with pegylated interferon-α2a plus ribavirin was associated with a greater decrease in HCV RNA at week 4 ; however , this did not translate into higher EVR rates . Higher RBV doses and avoidance of NRTI-sparing antiretroviral regimens might improve HCV treatment efficacy .
51648
Intervention_Pharmacological
ribavirin