Management of HIV/hepatitis C virus-coinfected patient non-responders to hepatitis C virus antiviral therapy and relapsers

Cristina Tural, Ramon Planas, Guillermo Sirera, Bonaventura Clotet

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

PURPOSE OF REVIEW: To examine recent developments in the management of HIV/hepatitis C virus-coinfected patients who relapsed or who responded poorly to initial therapy, with particular emphasis on peginterferon plus ribavirin. RECENT FINDINGS: End-stage liver disease is the first cause of non-AIDS-related mortality in patients on antiretroviral therapy. A pool analysis of recent studies suggested that only 33% of HIV/hepatitis C virus-coinfected patients will achieve sustained virological response with peginterferon plus ribavirin. A substudy of the APRICOT trial shows that this strategy will benefit liver histology even in non-responding patients. The management of side effects is important and, according to a recent study, erythropoietin can improve clinical outcomes of hepatitis C virus therapy, although no direct association between response and the control of haematological toxicity was demonstrated. Patients who did not clear hepatitis C virus RNA with a slow virological response to previous courses of peginterferon and ribavirin might benefit from prolonging therapy to up to 72 weeks. SUMMARY: Re-treatment strategies in non-responders to previous interferon-based therapies and relapsers should consider the previous virological response profile and ensure that treatment-related toxicity is controlled to avoid dose reductions or premature treatment interruptions. Further studies are needed to optimize therapeutic regimens. © 2007 Lippincott Williams & Wilkins, Inc.
Original languageEnglish
Pages (from-to)496-502
JournalCurrent Opinion in HIV and AIDS
Volume2
Issue number6
DOIs
Publication statusPublished - 1 Nov 2007

Keywords

  • Hepatitis C virus coinfection
  • Peginterferon
  • Re-treatment
  • Ribavirin
  • Sustained virological response

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