Peginterferon vs. interferon in the treatment of different HCV genotype infections in HIV patients

  • S. Zhao
  • D. Cheng
  • E. Liu
  • H. Yu
  • H. Yang
  • X. Xue
  • Y. Chu
Article

Abstract

It remains difficult to achieve high sustained response rates (SVRs) in chronic hepatitis patients coinfected with human immunodeficiency virus (HIV). The aim of this study was to perform a meta-analysis of randomized controlled trials (RCTs) comparing peginterferon with interferon in the treatment of patients carrying different genotypes of hepatitis C virus (HCV) and coinfected with HIV. A Medline literature search was conducted to identify RCTs evaluating SVRs to peginterferon and interferon in HCV/HIV-coinfected patients. Six studies matched the selection criteria, and the HCV genotype of 1,717 coinfected patients was reported. For genotypes 1 or 4 HCV and HIV-coinfected patients, both types of peginterferon, α-2a and α-2b, achieved higher SVRs compared with the respective types of interferon. The SVRs achieved in patients infected with HCV genotypes 1 or 4 treated with peginterferon and ribavirin was not satisfactory in comparison with those of patients infected with HCV genotypes 2 or 3 (26% vs. 55%). The probability of achieving higher SVRs in patients when treated with peginterferon plus ribavirin increased compared with other therapies, especially for patients coinfected with HCV genotypes 1 or 4 and HIV. The likelihoods of serious adverse effects and withdrawal rates were similar.

Abbreviations

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

SVR

Sustained response rate

PegIFN

Peginterferon

IFN

Interferon

RBV

Ribavirin

BW

Body weight

RR

Relative risk

CI

Confidence interval

Notes

Acknowledgment

This work was supported by the National Natural Science Foundation of China (grant no. 30470089).

References

  1. 1.
    [No authors listed] (1999) EASL International Consensus Conference on Hepatitis C. Paris, 26–28, February 1999, Consensus Statement. European Association for the Study of the Liver. J Hepatol 30:956–961CrossRefGoogle Scholar
  2. 2.
    Lauer GM, Walker BD (2001) Hepatitis C virus infection. N Engl J Med 345:41–52PubMedCrossRefGoogle Scholar
  3. 3.
    Quinn TC, Overbaugh J (2005) HIV/AIDS in women: an expanding epidemic. Science 308:1582–1583PubMedCrossRefGoogle Scholar
  4. 4.
    Rockstroh JK, Mocroft A, Soriano V, Tural C, Losso MH, Horban A, Kirk O, Phillips A, Ledergerber B, Lundgren J; EuroSIDA Study Group (2005) Influence of hepatitis C virus infection on HIV-1 disease progression and response to highly active antiretroviral therapy. J Infect Dis 192:992–1002PubMedCrossRefGoogle Scholar
  5. 5.
    Simmonds P (1999) Viral heterogeneity of the hepatitis C virus. J Hepatol 31(Suppl):54–60PubMedCrossRefGoogle Scholar
  6. 6.
    Zein NN, Rakela J, Krawitt EL, Reddy KR, Tominga T, Persing DH (1996) Hepatitis C virus genotypes in the United States: epidemiology, pathogenicity, and response to interferon therapy. Collaborative Study Group. Ann Intern Med 125:634–639PubMedGoogle Scholar
  7. 7.
    Chinese Society of Hepatology and Chinese Society of Lemology and Parasitology (2004) Guideline for prevention and treatment of hepatitis C in China. Zhonghua Gan Zang Bing Za Zhi 12:194–199Google Scholar
  8. 8.
    Lewden C, Salmon D, Morlat P, Bévilacqua S, Jougla E, Bonnet F, Héripret L, Costagliola D, May T, Chêne G: Mortality 2000 study group (2005) Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemol 34:121–130CrossRefGoogle Scholar
  9. 9.
    Keefe EB (2003) Peginterferons in hepatitis C virus: virological, pharmacokinetic, and clinical implications. Introduction. Semin Liver Dis 23(Suppl 1):1–2Google Scholar
  10. 10.
    Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, Goodman ZD, Koury K, Ling M, Albrecht JK (2001) Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 358:958–965PubMedCrossRefGoogle Scholar
  11. 11.
    Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Gonçales FL Jr, Häussinger D, Diago M, Carosi G, Dhumeaux D, Craxi A, Lin A, Hoffman J, Yu J (2002) Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 347:975–982PubMedCrossRefGoogle Scholar
  12. 12.
    Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Marcellin P, Ramadori G, Bodenheimer H Jr, Bernstein D, Rizzetto M, Zeuzem S, Pockros PJ, Lin A, Ackrill AM; PEGASYS International Study Group (2004) Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 140:346–355PubMedGoogle Scholar
  13. 13.
    Kim AI, Saab S (2005) Treatment of hepatitis C. Am J Med 118:808–815PubMedCrossRefGoogle Scholar
  14. 14.
    Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedGoogle Scholar
  15. 15.
    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188PubMedCrossRefGoogle Scholar
  16. 16.
    Egger M, Smith GD, Phillips AN (1997) Meta-analysis: principles and procedures. BMJ 315:1533–1537PubMedGoogle Scholar
  17. 17.
    Chung RT, Andersen J, Volberding P, Robbins GK, Liu T, Sherman KE, Peters MG, Koziel MJ, Bhan AK, Alston B, Colquhoun D, Nevin T, Harb G, van der Horst C; AIDS Clinical Trials Group A5071 Study Team (2004) Peginterferon alfa-2a plus ribavirin versus interferon alfa-2a plus ribavirin for chronic hepatitis C in HIV-coinfected persons. N Engl J Med 351:451–459PubMedCrossRefGoogle Scholar
  18. 18.
    Torriani FJ, Rodriguez-Torres M, Rockstroh JK, Lissen E, Gonzalez-García J, Lazzarin A, Carosi G, Sasadeusz J, Katlama C, Montaner J, Sette H Jr, Passe S, De Pamphilis J, Duff F, Schrenk UM, Dieterich DT; APRICOT Study Group (2004) Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. N Engl J Med 351:438–450PubMedCrossRefGoogle Scholar
  19. 19.
    Cargnel A, Angeli E, Mainini A, Gubertini G, Giorgi R, Schiavini M, Duca P; Italian Co-infection Study (ICOS) Group (2005) 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 10:309–317PubMedGoogle Scholar
  20. 20.
    Carrat F, Bani-Sadr F, Pol S, Rosenthal E, Lunel-Fabiani F, Benzekri A, Morand P, Goujard C, Pialoux G, Piroth L, Salmon-Céron D, Degott C, Cacoub P, Perronne C; ANRS HCO2 RIBAVIC Study Team (2004) Pegylated interferon alfa-2b vs standard interferon alfa-2b, plus ribavirin, for chronic hepatitis C in HIV-infected patients: a randomized controlled trial. JAMA 292:2839–2848PubMedCrossRefGoogle Scholar
  21. 21.
    Crespo M, Sauleda S, Esteban JI, Juarez A, Ribera E, Andreu AL, Falco V, Quer J, Ocaña I, Ruiz I, Buti M, Pahissa A, Esteban R, Guardia J (2007) Peginterferon alpha-2b plus ribavirin vs interferon alpha-2b plus ribavirin for chronic hepatitis C in HIV-coinfected patients. J Viral Hepat 14:228–238PubMedCrossRefGoogle Scholar
  22. 22.
    Laguno M, Murillas J, Blanco JL, Martínez E, Miquel R, Sánchez-Tapias JM, Bargallo X, García-Criado A, de Lazzari E, Larrousse M, León A, Loncá M, Milinkovic A, Gatell JM, Mallolas J (2004) Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for treatment of HIV/HCV co-infected patients. AIDS 18:F27–F36PubMedCrossRefGoogle Scholar
  23. 23.
    Kim AI, Dorn A, Bouajram R, Saab S (2007) The treatment of chronic hepatitis C in HIV-infected patients: a meta-analysis. HIV Med 8:312–321PubMedCrossRefGoogle Scholar
  24. 24.
    Shire NJ, Welge JA, Sherman KE (2007) Response rates to pegylated interferon and ribavirin in HCV/HIV coinfection: a research synthesis. J Viral Hepat 14:239–248PubMedCrossRefGoogle Scholar
  25. 25.
    Zeuzem S (2004) Heterogeneous virologic response rates to interferon-based therapy in patients with chronic hepatitis C: who responds less well? Ann Intern Med 140:370–381PubMedGoogle Scholar
  26. 26.
    Neumann AU, Lam NP, Dahari H, Davidian M, Wiley TE, Mika BP, Perelson AS, Layden TJ (2000) Differences in viral dynamics between genotypes 1 and 2 of hepatitis C virus. J Infect Dis 182:28–35PubMedCrossRefGoogle Scholar
  27. 27.
    Pawlotsky JM, Hezode C, Pellegrin B, Soulier A, Wagner M, Brouwer JT, Missale G, Germanidis G, Lurie Y, Negro F, Esteban JI, Hellstrand K, Ferrari C, Zeuzem S, Schalm SW, Neumann AU (2002) Early HCV genotype 4 replication kinetics during treatment with peginterferon alfa-2A (Pegasys)-ribavirin combination. A comparison with HCV genotypes 1 and 3 (abstract). Hepatology 36:291CrossRefGoogle Scholar
  28. 28.
    Ballesteros AL, Franco S, Fuster D, Planas R, Martínez MA, Acosta L, Sirera G, Salas A, Tor J, Rey-Joly C, Clotet B, Tural C (2004) Early HCV dynamics on Peg-interferon and ribavirin in HIV/HCV co-infection: indications for the investigation of new treatment approaches. AIDS 18:59–66PubMedCrossRefGoogle Scholar
  29. 29.
    Hézode C, Roudot-Thoraval F, Zafrani ES, Dhumeaux D, Pawlotsky JM (2004) Different mechanisms of steatosis in hepatitis C virus genotypes 1 and 3 infections. J Viral Hepat 11:455–458PubMedCrossRefGoogle Scholar
  30. 30.
    Voigt E, Schulz C, Klausen G, Goelz J, Mauss S, Schmutz G, Jessen H, Weitner L, Mutz A, Schranz D, Rockstroh JK; Kaad Study Group (2006) Pegylated interferon alpha-2b plus ribavirin for the treatment of chronic hepatitis C in HIV-coinfected patients. J Infect 53:36–42PubMedCrossRefGoogle Scholar
  31. 31.
    Mauss S, Rockstroh JK (2005) HCV/HIV-coinfection—is there a state of the art after APRICOT and RIBAVIC? J Antimicrob Chemother 56:615–618PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • S. Zhao
    • 1
    • 2
  • D. Cheng
    • 3
  • E. Liu
    • 2
  • H. Yu
    • 4
  • H. Yang
    • 5
  • X. Xue
    • 1
  • Y. Chu
    • 1
  1. 1.Department of Immunology and MicrobiologyXi’an Jiaotong University School of MedicineShaanxiChina
  2. 2.Laboratory Animal CenterXi’an Jiaotong University School of MedicineShaanxiChina
  3. 3.Department of Pediatrics of the First Affiliated HospitalXi’an Jiaotong University School of MedicineShaanxiChina
  4. 4.Department of Hepatobiliary SurgeryThe First Affiliated Hospital of Xi’an Jiaotong UniversityShaanxiChina
  5. 5.Department of Public HealthXi’an Jiaotong University School of MedicineShaanxiChina

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