Abstract
Background
Current guidelines recommend that interferon-based treatment of hepatitis C (HCV) genotype 2 or 3 in those with HIV coinfection should be for 48 weeks, especially if HCV PCR remains positive after 4 weeks of treatment.
Aim
To examine a single-center experience using response-guided therapy (RGT) using pegylated interferon (PegIFN) and weight-based ribavirin (RBV) for treating HCV genotype 2 or 3 in those with HIV coinfection.
Methods
Electronic medical records were used to identify patients with HCV genotype 2 or 3 HIV coinfection seen at the Toronto General Hospital Immunodeficiency Clinic from February 2003 to December 2012. HCV PCR was tested after every 4 weeks of treatment until it was negative (<50 IU/mL). RGT protocol was as follows: Those with HCV PCR first negative after 4 weeks (VR4) were treated 24 weeks; first negative after 8 weeks (VR8) treated 36 weeks and VR12 treated 48 weeks.
Result
Database search identified 35 individuals with HCV genotype 2 or 3. Twelve were excluded. Total 23 patients completed the treatment and were included for data analysis. Eleven of 23 (48 %) achieved VR4 and eleven of 23 (48 %) achieved VR8. Only one individual had detectable viremia to week 12 and required 48 weeks of treatment. The majority (96 %) were successfully treated with <48 weeks of PegIFN–RBV therapy. One hundred percent achieved SVR with a response-guided HCV therapy.
Conclusion
The use of response-guided therapy allows therapy to be shortened in the majority of individuals. HCV PCR testing should be performed every 4 weeks during the first 12 weeks of therapy until HCV PCR is negative.
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Acknowledgments
The authors acknowledge the critical role played by the HIV clinic nurses at the Toronto General Hospital Immunodeficiency Unit involved with HCV treatment: Pauline Murphy, Christine Walach, and Joanne Daly.
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Win, L.L., James, P. & Wong, D.K. Response-Guided Therapy for Hepatitis C Genotype 2 and 3 in Those with HIV Coinfection. Dig Dis Sci 59, 1946–1949 (2014). https://doi.org/10.1007/s10620-014-3211-6
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DOI: https://doi.org/10.1007/s10620-014-3211-6