Treatment of Chronic Hepatitis C in HIV/HCV- Coinfection With Interferon -2b Full-Course

Human immunodeficiency virus (HIV)-infected patients increasingly experience the conse-quences of chronic hepatitis C virus (HCV) coinfection. This trial randomized 107 patients coinfected withHIV andHCV to receive 48 weeks of interferon alfa-2b (IFN) 3million units three times weekly plus either a full course of ribavirin (RBV) at 800 mg/day (group A; n 53) or 16 weeks of placebo, followed by RBV (group B; n 54). The primary endpoint of sustained viral response (SVR) rate (undetectable HCV RNA at posttreatment week 24) was not different between groups A (11.3%) and B (5.6%; P .32). Within group A, the SVR rate was lower in genotype 1 (2.5%) than in genotypes 2 through 4 (41.7%; P .002). Fifty-five patients discontinued therapy prematurely, mostly because of adverse events or patient decisions. At treatment week 12, the percentage of CD4 cells rose in group A (4.1%; P<.001), but not in group B (0.3%). A significant proportion (22%) of patients who were HIV viremic at baseline had undetectable HIV RNA at week 12. By week 16, the hemoglobin level decreased more in group A (2,52 g/dL) than in group B (1.02 g/dL; P<.001). In group A, the hemoglobin decline was steeper in patients receiving zidovudine (azidothymidine [AZT], 3.64 g/dL vs. no AZT, 2.08 g/dL), and patients receivin