icon-folder.gif   Conference Reports for NATAP  
  9th European AIDS Conference (EACS)
Warsaw, Poland
Oct 25-29, 2003
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Pegasys plus Ribavirin for HCV Treatment in HIV/HCV Coinfection in spain: PRESCO Study
  Reported by Jules Levin
Soriano V. and colleagues at Hospital Carlos III, Madrid, Spain

The growing morbidity/mortality due to liver disease among HIV/HCV-coinfected patients highlights the need for eradication of HCV infection. Preliminary data suggest a lower response to anti-HCV treatments in the setting of HIV coinfection.
The aim of this study was to assess the efficacy and safety of pegIFN-_2a (Pegasys) 180 microg/week plus ribavirin (RBV) 1000-1200 mg/day for the treatment of chronic hepatitis C in HIV-coinfected subjects.
PRESCO is an ongoing multicenter, prospective trial, in which HIV+ adults from 35 HIV spanish clinics, with HCV-RNA +, elevated transaminases, >300 CD4 cells/mm3, and no Child B/C cirrhosis nor ddI use, are invited to participate.
A 12-week time-point is used to assess early virologic response (>2 log drop in HCV-RNA), and only patients achieving it are allow to continue on therapy (6 or 12 months those with HCV genotypes 2 or 3 and 12 to 18 those with HCV 1 or 4).
Out of 300 planned patients, 115 have been recruited up to June 2003. HCV genotype distribution is: 1/4 in 71% and 2/3 in 29%. Mean age, 36 years. Mean CD4 count, 464 cells/mm3. Mean HCV-RNA, 745,062 IU/mL.
At 12 weeks, 83% of patients had HCV-RNA drops > 2 logs This figure was 55% at week 4. Adverse events leading to treatment discontinuation before week 12 occurred in 23% of patients.
The authors concluded that PegIFN-_2a plus RBV is relatively safe in HCV/HIV-coinfected patients. In contrast with previous trials, the early virological response seems to be similar to that seen in HCV-monoinfected patients.