New Drug Combination More Effective at Treating People Co-Infected With HIV, Hepatitis C, NEJM Studies Say

A new drug combination that includes a chemically modified form of interferon known as peginterferon is much more effective in treating hepatitis C in patients co-infected with HIV than the standard hepatitis C treatment, according to two studies published in the July 29 issue of the New England Journal of Medicine, Reuters reports. Approximately 300,000 HIV-positive people in the United States also have hepatitis C; the standard treatment for hepatitis C is ribavirin and interferon, which is a synthetic version of a naturally occurring immune system protein. The new studies examined the use of peginterferon, which stays active in the body for a longer period of time than interferon. The first study, conducted by Raymond Chung of Massachusetts General Hospital and colleagues, found that the hepatitis C virus was suppressed in 27% of the 66 patients co-infected with HIV who were treated with peginterferon and ribavirin for 48 weeks, compared with 12% of the 67 HIV-positive patients who received interferon and ribavirin for the same period of time, Reuters reports (Emery, Reuters, 7/28).

Second Study
Francesca Torriani of the University of California-San Diego and colleagues conducted a similar study among nearly 900 people in 19 countries, all of whom were co-infected with HIV and hepatitis C, Agence France-Presse reports (Agence France-Presse, 7/28). The patients were randomly assigned to receive either a regimen of peginterferon and ribavirin; peginterferon and a placebo; or interferon and ribavirin for 48 weeks and were monitored for an additional 24 weeks to determine virologic response (Torriani et al., New England Journal of Medicine, 7/29). Approximately 40% of the individuals on the peginterferon-ribavirin therapy had undetectable hepatitis C viral levels at the end of the study period, compared with 20% of individuals taking peginterferon and placebo and 12% of individuals on the interferon-ribavirin therapy. In addition, both studies found that treatment regimens including peginterferon did not affect patients' antiretroviral drug regimens. However, success rates varied depending on the individual's type of hepatitis C infection, according to Reuters. Roche, which sells peginterferon under the brand name Pegasys, funded the second study (Reuters, 7/28). The improved treatment regimen represents important progress because hepatitis C-related liver disease has become the leading cause of death for HIV-positive people in the United States, the Cincinnati Enquirer reports. "Just a decade ago, treatment (of hepatitis C) in persons with HIV was not a priority because they died from AIDS before developing serious complications of hepatitis C infection," National Institute of Allergy and Infectious Diseases Director Anthony Fauci said (Bonfield, Cincinnati Enquirer, 7/30).