Background
This study aimed to assess the relationship between IFN related adverse effects and HCV virologic response in HIV/HCV co-infected individuals treated with pegylated interferon and ribavirin.
Methods
We conducted two prospective, open-label trials treating HIV/HCV co-infected individuals with peg-IFN alpha-2b or alpha-2a and ribavirin for 48 weeks. Safety labs, HCV RNA, psychiatric and ophthalmologic evaluations were performed at baseline, and monthly until week 72.
Results
Responders were defined as those with HCV RNA decline of ≥ 2-log drop from baseline and non-responders were those who did not. Remarkably, of the 27 patients who (50%) developed psychiatric toxicities, twenty-six patients were responders, while only one of fourteen virologic non-responders experienced psychiatric toxicity. Other adverse effects such as anemia and ophthalmologic toxicities, were also more frequent in responders compared to non-responders. Decline in CD4+ T cell counts strongly correlated with HCV viral decline.
Conclusion
Our study demonstrate coupling of antiviral effect and occurrence of adverse events in HIV/HCV co-infected patients. These patients with IFN-related adverse effects need a multidisciplinary treatment approach, hence they are more likely to achieve SVR. Future studies are needed to evaluate the factors that predict the development of IFN-α dependent adverse events prior to therapy.