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Trop Med Int Health. 2018 Mar;23(3):295-305. doi: 10.1111/tmi.13027. Epub 2018 Jan 10.

Peg-interferon and ribavirin treatment in HIV/HCV co-infected patients in Thailand: efficacy, safety and pharmacokinetics.

Author information

1
Department of Pharmacy & Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
2
HIV-Netherlands Australia Thailand Research Collaboration, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
3
Department of Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands.
4
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
5
Department of Medicine, Bamrasnaradura Institute, Nonthaburi, Thailand.
6
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Abstract

OBJECTIVE:

In Thailand, 7.2% of HIV patients are co-infected with hepatitis C virus (HCV), and these patients are treated with peg-interferon + ribavirin (PR) for their HCV infection. This study evaluates efficacy and safety of PR treatment and pharmacokinetics of ribavirin in this population.

METHODS:

HIV/HCV co-infected Thai patients were treated with PR for 24 or 48 weeks. Sustained virological response 24 weeks after the end of treatment (SVR24) was used to describe efficacy. (laboratory) safety parameters and ribavirin plasma concentrations were evaluated during study visits. Ribavirin concentrations were compared with t-tests for patients with and without anaemia (haemoglobin <10 g/dl) and SVR24.

RESULTS:

A total of 101 HIV/HCV co-infected patients were included; 88% were male (n = 88), and 46% were infected with genotype 3. The median (IQR) start dose was 14.28 mg/kg/day. SVR24 rate was 56%. All patients reported at least one (serious) adverse event, of which 28% of patients developed anaemia. Seven patients discontinued treatment due to toxicity issues. Geometric mean (IQR) ribavirin concentration was 1.81 (1.42-2.32) mg/l at week 8 of treatment. At week 8, patients with and without anaemia and SVR had ribavirin concentrations of 2.29 and 1.63 mg/l and 1.91 and 1.74 mg/l, respectively.

CONCLUSIONS:

PR treatment has comparable response rates and toxicity profile in Thai HIV/HCV co-infected patients as in Western HIV/HCV patients. However, ribavirin plasma concentrations were comparable with previously published studies in HIV/HCV co-infected patients, but both, just as SVR rate, were lower than in mono-infected patients.

KEYWORDS:

HIV ; VIH ; Thailand; Thaïlande; hepatitis C; hépatite C; suivi thérapeutique des médicaments; therapeutic drug monitoring

PMID:
29247579
DOI:
10.1111/tmi.13027
[Indexed for MEDLINE]
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