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Cargnel A, Angeli E, Mainini A, Gubertini G, Giorgi R, Schiavini M, Duca P, Scalise G, Cesare SD, Chiodo F, Verucchi G, Farci P, Serra G, Sagnelli E, Nacca C, Ferraro T, Scerbo A, Santoro D, Pusterla L, Viganò P, Magnani C, Ghinelli F, Sighinolfi L, Vigevani G, Pastecchia C, Moroni M, Milazzo L, Esposito R, Borghi V, Piccinino F, Filippini P, Cadrobbi P, Sattin A, Ferrari C, Antoni AD, Stagni G, Francisci D, Petrelli E, Alberici F, Sacchini D, Zauli T, Donà DD, Arlotti M, Mori F, Marranconi F, Caramello P, Lipani F, Soranzo ML, Macor A, Vaglia A, Rossi MC, Grossi P, Tambini R, De Lalla F, Tositti G. Open, Randomized, Multicentre Italian Trial on Peg-Ifn plus Ribavirin versus Peg-Ifn Monotherapy for Chronic Hepatitis C in HIV-Coinfected Patients on Haart. Antivir Ther 2005. [DOI: 10.1177/135965350501000215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Chronic hepatitis C is common and aggressive in HIV-positive patients, so the development of a well-tolerated HCV therapy is a priority. We evaluated the efficacy and safety of pegylated interferon α2b (PEG-IFN) plus ribavirin (RBV) versus PEG-IFN monotherapy in HIV/HCV-coinfected patients undergoing highly active antiretroviral therapy (HAART), and analysed the predictive factors of response. Methods An Italian, multicentre, open-label trial including 135 coinfected patients, randomized to PEG-IFN 1.5 μg/kg/week plus RBV 400 mg twice daily ( n=69, arm A) or PEG-IFN 1.5 μg/kg/week ( n=66, arm B) for 48 weeks. We assessed the predictive values of early virological response (EVR) at week 8 (HCV-RNA drop >2 log10 compared with baseline or undetectable levels) on sustained virological response (SVR). Results Fifty-five patients (28 from arm A and 27 from arm B) completed 48 weeks of therapy. At the end of treatment, 20/28 patients in arm A and 11/27 in arm B had HCV-RNA <50 IU/ml. In a per-protocol analysis, SVR was reached by 54% of patients in arm A (genotype 2–3, 11/16; genotype 1–4, 4/12) and 22% in arm B (genotype 2–3, 3/15; genotype 1–4, 3/12). In an intention-to-treat analysis, the SVR was 22% in arm A (genotype 2–3, 11/32; genotype 1–4, 4/37) versus 9% in arm B (genotype 2–3, 3/32; genotype 1–4, 3/34). The best predictors of SVR were the use of combination therapy, infection with HCV genotype 3 versus genotype 1, and EVR at week 8. Thirty patients (15 from arm A and 15 from arm B) dropped out of the trial prematurely due to side effects. The positive predictive value of EVR at week 8 was 65%, the negative predictive value was 86%. Conclusions PEG-IFN plus RBV can be considered a solid option for the treatment of HIV/HCV-coinfected patients. The key to successfully improving efficacy is strong compliance through strict overall patient monitoring, in order to best manage drug toxicity. EVR assessment at week 8 may become a useful stategy in the management of therapy.
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Affiliation(s)
| | | | - Elena Angeli
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Annalisa Mainini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Guido Gubertini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Riccardo Giorgi
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Monica Schiavini
- II Department Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
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Perno CF, Cozzi-Lepri A, Balotta C, Forbici F, Violin M, Bertoli A, Facchi G, Pezzotti P, Angarano G, Arici C, Narciso P, Orani A, Raise E, Scalzini A, Poggio A, Ippolito G, Moroni M, Monforte AD, Montroni M, Scalise G, Costantini A, Del Prete MS, Tirelli U, Nasti G, Pastore G, Perulli LM, Suter F, Arici C, Chiodo F, Gritti FM, Colangeli V, Fiorini C, Guerra L, Carosi G, Cadeo GP, Castelli F, Minardi C, Vangi D, Rizzardini G, Migliorino G, Manconi PE, Piano P, Ferraro T, Cosco L, Pizzigallo E, Ricci F, Vigevani GM, Pusterla L, Carnevale G, Pan A, Viganò P, Mena M, Ghinelli F, Sighinolfi L, Leoncini F, Mazzotta F, Ambu S, Lo Caputo S, Angarano G, Grisorio B, Ferrara S, Grima P, Tundo P, Pagano G, Piersantelli N, Alessandrini A, Piscopo R, Toti M, Chigiotti, Soscia F, Tacconi L, Orani A, Castaldo G, Scasso A, Vincenti A, Scalzini A, Alessi F, Moroni M, Lazzarin A, Cargnel A, Milazzo F, Caggese L, Monforte AD, Melzi S, Delfanti F, Carini B, Adriani B, Garavaglia S, Moioli C, Esposito R, Mussini C, Abrescia N, Chirianni A, Perrella O, Piazza M, De Marco M, Montesarchio V, Manzillo E, Nappa S, Cadrobbi P, Scaggiante R, Colomba A, Abbadesse V, Prestileo T, Mancuso S, Filice G, Minoli L, Savino FAP, Maserati R, Pauluzzi S, Baldelli F, Petrelli E, Ciotti A, Alberici F, Sisti M, Menichetti F, Smorfa A, De Stefano C, La Gala A, Zauli T, Ballardini G, Bonazzi L, Ursitti MA, Ciammarughi R, Giordani S, Ortona L, Dianzani F, Ippolito G, Antinori A, Antonucci G, D'Elia S, Narciso P, Petrosillo N, Vullo V, De Luca A, Del Forno A, Zaccarelli M, De Longis P, Ciardi M, D'Offizi G, Palmieri F, Lichter M, Capobianchi MR, Girardi E, Pezzotti P, Rezza G, Mura MS, Mannazzu M, Caramello P, Sinicco A, Soranzo ML, Quaglia S, Sciandra M, Salassa B, Torre D, Basilico C, Poggio A, Bottari G, Raise E, Pasquinucci S, De Lalla F, Tositti G, Resta F, Chimienti A, Lepri AC, Phillips AN. Impact of Mutations Conferring Reduced Susceptibility to Lamivudine on the Response to Antiretroviral Therapy. Antivir Ther 2001. [DOI: 10.1177/135965350100600306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Carlo Federico Perno
- IRCCS L. Spallanzani, Rome, Italy
- Department Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Claudia Balotta
- Institute of Tropical and Infectious Diseases, University of Milan, Milan, Italy
| | | | - Michela Violin
- Institute of Tropical and Infectious Diseases, University of Milan, Milan, Italy
| | | | - Guido Facchi
- Institute of Tropical and Infectious Diseases, University of Milan, Milan, Italy
| | | | | | - Claudio Arici
- Department of Infectious Diseases, Ospedali Riuniti, Bergamo, Italy
| | | | - Anna Orani
- Department of Infectious Diseases, Lecco Hospital, Lecco, Italy
| | - Enzo Raise
- Department of Infectious Diseases, SS Giovanni e Paolo Hospital, Venice, Italy
| | - Alfredo Scalzini
- Department of Infectious Diseases, Mantova Hospital, Mantova, Italy
| | - Antonio Poggio
- Department of Infectious Diseases, Verbania Hospital, Verbania, Italy
| | | | - Mauro Moroni
- Institute of Tropical and Infectious Diseases, University of Milan, Milan, Italy
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