Treatment with pegylated interferon alfa-2a and ribavirin yielded similar response rates in patients with HIV and HCV coinfection with elevated and persistently normal ALT in a study presented at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.
In the prospective, multicenter CONTRA study, researchers administered 180 mcg peginterferon-alfa-2a weekly and 1,000 mg to 1,200 mg ribavirin daily for 48 weeks to 80 patients coinfected with HIV and HCV. The cohort included 42 patients with normal ALT levels as measured five or more times within the prior 2 years (case group) and 38 patients with elevated ALT (controls). The two groups were similar with regard to age, sex, BMI, HCV genotype prevalence and HCV viral load.
Within the ITT population, sustained virologic response occurred at similar rates between the case (38%) and control groups (42%) (P=.7). Complete response also was observed in a similar number of participants between groups at week 4 (32% of cases vs. 33% of controls) and week 12 (49% vs. 60%) (P=.56).
Seventy-one percent of cases and 84% of controls experienced adverse events. Treatment discontinuation was required in 10% and 5% of patients, respectively, and one incident of opportunistic infection was observed in the control group. Treatment modification was required in 41% of cases and 45% of controls.
“The treatment with peginterferon-alfa-2a and ribavirin in coinfected patients with persistently normal ALT levels has a similar efficacy to the one observed in patients with elevated ALT serum,” the researchers concluded. “Regarding toxicity, no significant differences were detected between both groups. The same treatment criteria should be used in both types of coinfected patients.”
For more information:
von Wichmann MA. WEPE486: PegIFN-alfa-2a and Ribavirin in HIV-HCV Coinfected Patients with Persistently Normal Aminotransferase Levels: Final Results of the CONTRA Study. Presented at: IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.