Report Sixteen From Dallas

Update on Treating HCV-HIV Coinfection
Jules Levin, NATAP

This is an update of12 months data from Doug Dietrich's 6-month dataset he reported at ICAAC in Sept '99 on HIV-HCV co-infected individuals treated with IFN+RBV. In this small study, 20 HIV-infected individuals randomly received either IFN alone or IFN+RBV. At ICAAC Dietrich reported median HCV viral load was 600 copies/ml (5/7 had <400 copies/ml). At 4 months in study those who had received IFN alone (n=10) at baseline crossed over to receive IFN+RBVif their viral load was detectable. Dosages were IFN 3 MIU tiw (3x/week) + RBV 800 mg day. 

Dietrich reported that after 12 months of therapy, for those who started combination IFN+RBV at beginning of study: median HCV RNA was <600, median HIV RNA was <400 and CD4s were 312 (CD4s at baseline were 544). The baseline numbers for the IFN+RBV group was 325,000 HCV RNA and <400 HIV RNA. Since the HIV RNA was still <400 at month 12 this suggests that the clinical effect of combining RBV with AZT or d4T may not be negative for patients. A larger and longer study is needed to confirm this. As well, it would be helpful to conduct study looking at if RBV affected d4T or AZT in cells.

For the group who started with IFN alone their median baseline HCV RNA and HIV RNA was 5 million (and reduced to 98,000 at 12 months) and 1,500 copies/ml, respectively; CD4s were 190. After 3 months their HCV RNA HIV RNA were 4.35 million and 600 copies/ml, respectively; CD4s were 186. They added RBV at 4 months and at 6 months their HCV RNA and HIV RNA were 447,000 and <400, respectively; CD4s were 190. So HCV RNA was reduced about 1 log after adding RBV. After 9 months their HCV RNA was 176,000, after 12 months it was 98,000. And their HIV RNA was <400 copies/ml. (click here to view original ICAAC Report)