Response to treatment of chronic hepatitis C with interferon α in patients infected with HIV-1 is associated with higher CD4+ cell count

Abstract

The aim of this study was to assess the efficacy and tolerance of interferon alpha (IFN alpha) treatment of chronic hepatitis C in HIV-seropositive patients. Seventeen patients with actively replicating hepatitis C were consecutively enrolled and treated with IFN alpha 5 MIU three times a week and followed up for at least 6 months after cessation of treatment. Eight patients responded to IFN alpha therapy with a complete remission of signs of active hepatitis and viral replication (ALT, HCV-RNA) at the end of treatment with IFN alpha. A sustained complete remission (ALT, HCV-RNA) for at least 6 months after the end of treatment was achieved in five of these eight patients. Complete responders had higher CD4+ cell counts (median 525/microliter) compared to non-responders (median 245/microliter) (p< 0.001). All patients but one completed at least 4 months of treatment. No severe toxicity (> WHO grade 2) due to IFN alpha treatment occurred. The results indicate that IFN alpha treatment of chronic hepatitis C in HIV-seropositive patients is successful in a considerable number of cases. Success of treatment with IFN alpha is related to higher CD4+ cell counts.

Pilot Study of Interferon-α with and without Amantadine for the Treatment of Hepatitis C in HIV Co-infected Individuals on Antiretroviral Therapy

“…Furthermore, increased mitochontrial toxicity has been evoked in combination of ribavirin and other nucleoside analogues [11]. Interferon monotherapy has yielded low sustained response rates, and other effective drug combinations are unknown [12]. Amantadine has been proposed as a possible alternative to ribavirin based on experimental data and preliminary clinical trials in HIV-seronegative patients [13][14][15][16].…”

Issues in HIV/hepatitis C co-infection

“…One caveat is that the majority of these studies involved patients with relatively minor degrees of immunosuppression by HIV. In fact, a higher CD4 count has been shown to correlate with better sustained responses to IFN therapy [34]. More recently, the guanosine analogue ribavirin has been employed in combination with IFN.…”

Coinfection with hepatitis C virus and HIV: The challenges of management

“…The response to HCV therapy is dependent on CD4 cell count [29,30]. Moreover, patients with low CD4 counts are at higher risk for opportunistic infections after the initiation of HCV therapy [31].…”