Lack of suppression by ribavirin of HIV viraemia

Gilson, Richard; Semple, Malcolm G; Gill, S; Loveday, Clive; Tedder, Richard S.; Weller, I.V.D.

doi:10.1016/0140-6736(92)91867-8

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…101 Ribavirin was studied as an antiretroviral treatment and was found to be ineffective. [103][104][105][106][107][108] Most studies used 600 to 800 mg/d 103,105,108 because severe depletions of CD4 cell counts were observed with doses of 1200 to 1600 mg. 103,104 This has been attributed to a direct lymphotoxic effect of ribavirin therapy. 103 Finally, ribavirin may interfere with the antiretroviral effect of zidovudine, and potentiate the effect of didanosine.…”

Section: Therapy Of Hcv In Coinfected Patientsmentioning

confidence: 99%

Hepatitis C in Patients With Human Immunodeficiency Virus Infection

Bonacini¹,

Puoti²

2000

Arch Intern Med

110

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Hepatitis C (HCV) infection occurs in as many as 33% of the patients with human immunodeficiency virus (HIV) infection. In view of their improved survival, liver disease will become more clinically significant in patients coinfected with HIV/HCV. Several studies in patients with hemophilia have shown that coinfected patients develop earlier and more severe liver disease, including hepatocellular carcinoma. In nonhemophilic cohorts, lower CD4 counts are associated with an increased prevalence of cirrhosis. However, HCV infection does not seem to alter the natural history of HIV infection in most cases. Human immunodeficiency virus coinfection in pregnant women increases the risk of perinatal HCV transmission 2-fold, with more than 25% of occurrences involving transmission of both viruses: cesarean delivery significantly decreases this risk. The expanded use of highly active antiretroviral therapy may lead to further improvement in morbidity and mortality from HIV infection. Thus, the management of coexistent HCV liver disease will need to be formulated. We suggest that alcohol be disallowed. Interferon and ribavirin in combination are likely to become the therapy of choice, particularly in coinfected patients with higher CD4 counts, lower HCV viremia, and non-1 genotype. During treatment, complete blood cell counts need to be closely monitored. Future controlled trials will determine the efficacy and safety of long-acting interferon preparations. Administration of highly active antiretroviral therapy, with the intent to prevent decreases in CD4 counts, seems crucial in stemming liver disease progression. However, some drugs have clear-cut hepatotoxic potential and patients with known liver disease should be closely monitored. Arch Intern Med. 2000;160:3365-3373.

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