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PLoS One. 2015 Jul 28;10(7):e0133879. doi: 10.1371/journal.pone.0133879. eCollection 2015.

Ribavirin Concentrations Do Not Predict Sustained Virological Response in HIV/HCV-Coinfected Patients Treated with Ribavirin and Pegylated Interferon in the Swiss HIV Cohort Study.

Author information

1
Division of Infectious Diseases and Hospital Epidemiology, University Hospital, University of Zurich, Zurich, Switzerland.
2
Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.
3
Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland.
4
Institute of Microbiology, University Hospital, Lausanne, Switzerland.
5
Division of Infectious Diseases, University Hospital, Lausanne, Switzerland.
6
Division of Infectious Diseases, University Hospital, Geneva, Switzerland.
7
Division of Infectious Diseases, Cantonal Hospital, St. Gallen, Switzerland.
8
Division of Infectious Diseases and Hospital Epidemiology, University Hospital, Basle, Switzerland.
9
Ospedale Regionale, Lugano, Switzerland.
10
University Clinic of Infectious Diseases, University Hospital Berne and University of Berne, Berne, Switzerland.

Abstract

BACKGROUND:

Ribavirin (RBV) is an essential component of most current hepatitis C (HCV) treatment regimens and still standard of care in the combination with pegylated interferon (pegIFN) to treat chronic HCV in resource limited settings. Study results in HIV/HCV-coinfected patients are contradicting as to whether RBV concentration correlates with sustained virological response (SVR).

METHODS:

We included 262 HCV treatment naïve HIV/HCV-coinfected Swiss HIV Cohort Study (SHCS) participants treated with RBV and pegIFN between 01.01.2001-01.01.2010, 134 with HCV genotype (GT) 1/4, and 128 with GT 2/3 infections. RBV levels were measured retrospectively in stored plasma samples obtained between HCV treatment week 4 and end of therapy. Uni- and multivariable logistic regression analyses were used to evaluate the association between RBV concentration and SVR in GT 1/4 and GT 2/3 infections. The analyses were repeated stratified by treatment phase (week 4-12, 13-24, >24) and IL28B genotype (CC versus CT/TT).

RESULTS:

SVR rates were 35.1% in GT 1/4 and 70.3% in GT 2/3 infections. Overall, median RBV concentration was 2.0 mg/L in GT 1/4, and 1.9 mg/L in GT 2/3, and did not change significantly across treatment phases. Patients with SVR had similar RBV concentrations compared to patients without SVR in both HCV genotype groups. SVR was not associated with RBV levels ≥2.0 mg/L (GT 1/4, OR 1.19 [0.5-2.86]; GT 2/3, 1.94 [0.78-4.80]) and ≥2.5 mg/L (GT 1/4, 1.56 [0.64-3.84]; GT 2/3 2.72 [0.85-8.73]), regardless of treatment phase, and IL28B genotype.

CONCLUSION:

In HIV/HCV-coinfected patients treated with pegIFN/RBV, therapeutic drug monitoring of RBV concentrations does not enhance the chance of HCV cure, regardless of HCV genotype, treatment phase and IL28B genotype.

PMID:
26218843
PMCID:
PMC4517877
DOI:
10.1371/journal.pone.0133879
[Indexed for MEDLINE]
Free PMC Article

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