Study results announced in the journal AIDS show that people co-infected with HIV and hepatitis C could have better and earlier responses if they used peg-interferon twice a week for the first four weeks of treatment rather than the standard once-a-week injection.
Co-infected people generally experience faster liver disease and much lower success rates when treating their hepatitis C. Making the situation more challenging, co-infected people don’t yet have final data on how to use either of the two new HCV drugs that came to market this summer. In the meantime, new strategies need to be developed to improve the HCV cure rate for co-infected individuals.
This small study followed 19 people, 10 of whom injected peg-interferon twice a week for the first four weeks of treatment and then once a week for the other 48 weeks. The other group took it once a week for the full course. All of them also took weight-based, daily doses of ribavirin.
The average CD4 count was 500. Nearly everyone (84%) was male. All participants had HCV genotype 1 (the hardest to treat), and just over half of the study were African American.
The results showed that those on peg-interferon twice a week had lower HCV levels throughout treatment. More people on double dosing had larger decreases in HCV levels after one week (63% vs. 44%, 1.28 log vs. 0.17 log). More people in the same group also reached at least a 2 log decrease in HCV viral load by week 12 (63% vs. 44%).
Overall, African Americans showed better responses to the twice-a-week dose. Abnormal liver enzyme levels also returned to normal faster in the twice-a-week group.
On a negative note, side effects occurred slightly more often in those on peg-interferon twice a week. As well, two people from each group stopped treatment due to side effects.
Although these are promising results, it was still a small study, so more research will have to be done in a larger group of people to see if these results hold up.