Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV

Massimo Puoti, Barbara Zanni, Raffaele Bruno, Monica Airoldi, Stefania Rossi, Eugenia Quiros Roldan, Issa El Hamad, Francesca Moretti, Francesca Castelli, Paolo Sacchi, Gaetano Filice, Giampiero Carosi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Human immunodeficiency virus (HIV) co-infection accelerates progression of hepatitis C virus (HCV) toward cirrhosis. Thus, with the increase of life expectancy observed after introduction of combination antiretroviral treatment, liver disease is becoming an increasing cause of morbidity and mortality in HIV-infected patients. In addition, HCV co-infection blunts CD4 restoration induced by HAART and increases HAART hepatotoxicity. For all these reasons, anti-HCV treatment is mandatory in HIV seropositives. The perfect treatment of hepatitis C should not only be safe and effective, but it should not have any adverse impact on HIV diseases and concurrent anti-HIV therapy. Two drugs are currently licensed for treatment of HCV: interferon alfa (IFNα) and ribavirin. Three hundred and thirty-eight patients have been included in pilot studies on the efficacy and tolerability of IFNα monotherapy: 16% showed sustained response and 10% dropped out. No significant adverse impact of IFNα monotherapy on HIV diseases or antiretroviral treatment has been observed. IFNα and ribavirin in combination have been introduced more recently: only 88 patients were included in pilot studies published as full papers with a 25% sustained response and an 11% rate of drop outs. Anemia and cumulative toxicity with didanosine were the most important side effects of combination treatment, but it did not affect HIV disease progression. Higher rates of sustained response (33%) without increase of side effects have been observed in preliminary experiences with the new long-acting pegylated interferons in combination with ribavirin. The search for the perfect treatment continues.

Original languageEnglish
Pages (from-to)324-332
Number of pages9
JournalHIV Clinical Trials
Volume3
Issue number4
Publication statusPublished - 2002

Fingerprint

Ribavirin
Hepacivirus
Interferons
HIV
Virus Diseases
Interferon-alpha
Highly Active Antiretroviral Therapy
Therapeutics
Coinfection
Didanosine
Hepatitis C
Life Expectancy
Disease Progression
Liver Diseases
Anemia
Fibrosis
Morbidity
Mortality
Pharmaceutical Preparations

Keywords

  • Fibrosis
  • HCV
  • Hepatitis
  • HIV
  • Interferon alfa
  • Ribavirin

ASJC Scopus subject areas

  • Immunology
  • Virology

Cite this

Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV. / Puoti, Massimo; Zanni, Barbara; Bruno, Raffaele; Airoldi, Monica; Rossi, Stefania; Roldan, Eugenia Quiros; El Hamad, Issa; Moretti, Francesca; Castelli, Francesca; Sacchi, Paolo; Filice, Gaetano; Carosi, Giampiero.

In: HIV Clinical Trials, Vol. 3, No. 4, 2002, p. 324-332.

Research output: Contribution to journalArticle

Puoti, M, Zanni, B, Bruno, R, Airoldi, M, Rossi, S, Roldan, EQ, El Hamad, I, Moretti, F, Castelli, F, Sacchi, P, Filice, G & Carosi, G 2002, 'Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV', HIV Clinical Trials, vol. 3, no. 4, pp. 324-332.
Puoti, Massimo ; Zanni, Barbara ; Bruno, Raffaele ; Airoldi, Monica ; Rossi, Stefania ; Roldan, Eugenia Quiros ; El Hamad, Issa ; Moretti, Francesca ; Castelli, Francesca ; Sacchi, Paolo ; Filice, Gaetano ; Carosi, Giampiero. / Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV. In: HIV Clinical Trials. 2002 ; Vol. 3, No. 4. pp. 324-332.
@article{838b643953a8482caea5e59198f62168,
title = "Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV",
abstract = "Human immunodeficiency virus (HIV) co-infection accelerates progression of hepatitis C virus (HCV) toward cirrhosis. Thus, with the increase of life expectancy observed after introduction of combination antiretroviral treatment, liver disease is becoming an increasing cause of morbidity and mortality in HIV-infected patients. In addition, HCV co-infection blunts CD4 restoration induced by HAART and increases HAART hepatotoxicity. For all these reasons, anti-HCV treatment is mandatory in HIV seropositives. The perfect treatment of hepatitis C should not only be safe and effective, but it should not have any adverse impact on HIV diseases and concurrent anti-HIV therapy. Two drugs are currently licensed for treatment of HCV: interferon alfa (IFNα) and ribavirin. Three hundred and thirty-eight patients have been included in pilot studies on the efficacy and tolerability of IFNα monotherapy: 16{\%} showed sustained response and 10{\%} dropped out. No significant adverse impact of IFNα monotherapy on HIV diseases or antiretroviral treatment has been observed. IFNα and ribavirin in combination have been introduced more recently: only 88 patients were included in pilot studies published as full papers with a 25{\%} sustained response and an 11{\%} rate of drop outs. Anemia and cumulative toxicity with didanosine were the most important side effects of combination treatment, but it did not affect HIV disease progression. Higher rates of sustained response (33{\%}) without increase of side effects have been observed in preliminary experiences with the new long-acting pegylated interferons in combination with ribavirin. The search for the perfect treatment continues.",
keywords = "Fibrosis, HCV, Hepatitis, HIV, Interferon alfa, Ribavirin",
author = "Massimo Puoti and Barbara Zanni and Raffaele Bruno and Monica Airoldi and Stefania Rossi and Roldan, {Eugenia Quiros} and {El Hamad}, Issa and Francesca Moretti and Francesca Castelli and Paolo Sacchi and Gaetano Filice and Giampiero Carosi",
year = "2002",
language = "English",
volume = "3",
pages = "324--332",
journal = "HIV Clinical Trials",
issn = "1528-4336",
publisher = "Taylor and Francis Ltd.",
number = "4",

}

TY - JOUR

T1 - Clinical experiences with interferon as monotherapy or in combination with ribavirin in patients co-infected with HIV and HCV

AU - Puoti, Massimo

AU - Zanni, Barbara

AU - Bruno, Raffaele

AU - Airoldi, Monica

AU - Rossi, Stefania

AU - Roldan, Eugenia Quiros

AU - El Hamad, Issa

AU - Moretti, Francesca

AU - Castelli, Francesca

AU - Sacchi, Paolo

AU - Filice, Gaetano

AU - Carosi, Giampiero

PY - 2002

Y1 - 2002

N2 - Human immunodeficiency virus (HIV) co-infection accelerates progression of hepatitis C virus (HCV) toward cirrhosis. Thus, with the increase of life expectancy observed after introduction of combination antiretroviral treatment, liver disease is becoming an increasing cause of morbidity and mortality in HIV-infected patients. In addition, HCV co-infection blunts CD4 restoration induced by HAART and increases HAART hepatotoxicity. For all these reasons, anti-HCV treatment is mandatory in HIV seropositives. The perfect treatment of hepatitis C should not only be safe and effective, but it should not have any adverse impact on HIV diseases and concurrent anti-HIV therapy. Two drugs are currently licensed for treatment of HCV: interferon alfa (IFNα) and ribavirin. Three hundred and thirty-eight patients have been included in pilot studies on the efficacy and tolerability of IFNα monotherapy: 16% showed sustained response and 10% dropped out. No significant adverse impact of IFNα monotherapy on HIV diseases or antiretroviral treatment has been observed. IFNα and ribavirin in combination have been introduced more recently: only 88 patients were included in pilot studies published as full papers with a 25% sustained response and an 11% rate of drop outs. Anemia and cumulative toxicity with didanosine were the most important side effects of combination treatment, but it did not affect HIV disease progression. Higher rates of sustained response (33%) without increase of side effects have been observed in preliminary experiences with the new long-acting pegylated interferons in combination with ribavirin. The search for the perfect treatment continues.

AB - Human immunodeficiency virus (HIV) co-infection accelerates progression of hepatitis C virus (HCV) toward cirrhosis. Thus, with the increase of life expectancy observed after introduction of combination antiretroviral treatment, liver disease is becoming an increasing cause of morbidity and mortality in HIV-infected patients. In addition, HCV co-infection blunts CD4 restoration induced by HAART and increases HAART hepatotoxicity. For all these reasons, anti-HCV treatment is mandatory in HIV seropositives. The perfect treatment of hepatitis C should not only be safe and effective, but it should not have any adverse impact on HIV diseases and concurrent anti-HIV therapy. Two drugs are currently licensed for treatment of HCV: interferon alfa (IFNα) and ribavirin. Three hundred and thirty-eight patients have been included in pilot studies on the efficacy and tolerability of IFNα monotherapy: 16% showed sustained response and 10% dropped out. No significant adverse impact of IFNα monotherapy on HIV diseases or antiretroviral treatment has been observed. IFNα and ribavirin in combination have been introduced more recently: only 88 patients were included in pilot studies published as full papers with a 25% sustained response and an 11% rate of drop outs. Anemia and cumulative toxicity with didanosine were the most important side effects of combination treatment, but it did not affect HIV disease progression. Higher rates of sustained response (33%) without increase of side effects have been observed in preliminary experiences with the new long-acting pegylated interferons in combination with ribavirin. The search for the perfect treatment continues.

KW - Fibrosis

KW - HCV

KW - Hepatitis

KW - HIV

KW - Interferon alfa

KW - Ribavirin

UR - http://www.scopus.com/inward/record.url?scp=0035986084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035986084&partnerID=8YFLogxK

M3 - Article

C2 - 12187507

AN - SCOPUS:0035986084

VL - 3

SP - 324

EP - 332

JO - HIV Clinical Trials

JF - HIV Clinical Trials

SN - 1528-4336

IS - 4

ER -