Peg‐interferon and ribavirin treatment in HIV HIV / HCV HCV co‐infected patients in Thailand: efficacy, safety and pharmacokinetics

摘要

Abstract Objective In Thailand, 7.2% of HIV patients are co‐infected with hepatitis C virus ( HCV ), and these patients are treated with peg‐interferon + ribavirin ( PR ) for their HCV infection. This study evaluates efficacy and safety of PR treatment and pharmacokinetics of ribavirin in this population. Methods HIV / HCV co‐infected Thai patients were treated with PR for 24 or 48 weeks. Sustained virological response 24 weeks after the end of treatment ( SVR 24) was used to describe efficacy. (laboratory) safety parameters and ribavirin plasma concentrations were evaluated during study visits. Ribavirin concentrations were compared with t ‐tests for patients with and without anaemia (haemoglobin 10 g/dl) and SVR 24. Results A total of 101 HIV / HCV co‐infected patients were included; 88% were male ( n = 88), and 46% were infected with genotype 3. The median ( IQR ) start dose was 14.28 mg/kg/day. SVR 24 rate was 56%. All patients reported at least one (serious) adverse event, of which 28% of patients developed anaemia. Seven patients discontinued treatment due to toxicity issues. Geometric mean ( IQR ) ribavirin concentration was 1.81 (1.42–2.32) mg/l at week 8 of treatment. At week 8, patients with and without anaemia and SVR had ribavirin concentrations of 2.29 and 1.63 mg/l and 1.91 and 1.74 mg/l, respectively. Conclusions PR treatment has comparable response rates and toxicity profile in Thai HIV / HCV co‐infected patients as in Western HIV / HCV patients. However, ribavirin plasma concentrations were comparable with previously published studies in HIV / HCV co‐infected patients, but both, just as SVR rate, were lower than in mono‐infected patients.