科研之友
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摘要
background: the rapid progression of chronic hepatitis c (chc) in hiv-infected patients is now the most important cause of morbidity, mortality and hospital admissions. in order to avoid this evolution, the treatment of chc is a major challenge in these patients. patients and method: the aim of this study is to evaluate the safety and efficacy of treatment of chc in hiv-infected patients with subcutaneous ifn (3 mu 3 times a week) plus ribavirin (rbv) administered per os depending on their body weight, for 24 weeks for genotype 2 or 3 and 48 weeks for genotype 1 or 4. all the patients have a cd4 count over 150 cells/米l and hiv viral load %26lt; 5,000 copies/ml, with or without antiretroviral treatment. we defined sustained response as rna-vhc below level of detection 24 weeks after the end of treatment. results: we included 28 patients in the study, with median age of 36,6 y.o. 81% of the patients were on antiretroviral treatment, with azt in 60% of them. genotype distribution was hcv-1 in 50%, hcv-3 in 35,7%, hcv-4 in 10,7% and hcv-2 in 3%. liver biopsy was performed in all the patients. adverse events leading to treatment discontinuation occurred in 5 patients (17,8%). the overall sustained response rate in the intent-to-treat analysis was 25,8% (50% for genotype 3 and 14% for genotype 1). conclusion: this therapy provides cure in a rate significantly lower than that seen in hcv-monoinfected individuals, with a similar safety. the modern formulations of ifn (pegylated) will provide new expectatives in this group of patients.
