Research article

Fast relapse and high drop out rate of 48 weeks daily interferon monotherapy in HIV-infected patients with chronic hepatitis C

Raffaele Bruno¹ , Paolo Sacchi¹ , Massimo Puoti² , Valentina Ciappina¹ , Cristina Zocchetti¹ , Enrico Brunetti¹ , Elena Maffezzini¹ , Anna Capelli¹ , Savino FA Patruno¹ , Antonello Malfitano¹ and Gaetano Filice¹

¹  Division of Infectious and Tropical Disease – IRCCS "San Matteo" Hospital, Pavia – University of Pavia, Pavia, Italy

²  Infectious and Tropical Disease Department – "Spedali Civili" Brescia Hospital, Brescia – University of Brescia, Brescia, Italy

author email corresponding author email

BMC Infectious Diseases 2002, 2:17doi:10.1186/1471-2334-2-17

Published:	28 August 2002

Abstract

Background

The standard of care for HCV Hepatitis is the combination of interferon (IFN) plus Ribavirin. In HIV patients the use of this combination therapy may induce drug interactions, and reduces the adherence to HAART.

The aim of this study is to evaluate safety and efficacy of a 48 weeks daily dose IFN schedule.

Methods

We evaluated 50 coinfected patients; alpha IFN 2a was administered at a dose of 3 MU daily. The baseline values were the following : CD4+ 515 cells/mmc (mean); HIV-RNA <50 copies/ml in all patients; HCV-RNA 28, 3 × 106 copies/ml.

Results

At 48 weeks, 10 patients (20%) achieved a biochemical and virological response according to an intention to treat analysis.

Twenty four patients (48%) underwent a drop-out mainly by side effects related to overlapping toxicity of interferon and antiretroviral therapy. All the patients, who responded to the treatment, showed a fast relapse one month after the end of treatment.

Conclusion

Although our results demonstrated a very poor outcome and a bad tolerance to interferon monotherapy, this approach should not be dropped out, mainly in patients at high risk for side effects and in those with cirrhosis who do not tolerate or are at increased risk for the use of ribavirin.