Ribavirin in combination therapy for HCV chronic infection in HIV patients: How to win the war after winning the first battle?

Souvignet, Claude; Maynard, Marianne; Gagnieu, Marie‐Claude; Trépo, C.

doi:10.1016/j.jhep.2007.04.001

Cited by 1 publication

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“…In addition, hemoglobin level was higher in coinfected than in monoinfected patients. It is well known that RBV is highly concentrated in red blood cells [23], but this parameter was not expected to influence AUC 0-4h which was determined after a single dose of RBV. Among other parameters known to have an influence on RBV exposure is the renal function, but neither median baseline serum creatinine, nor estimated glomerular filtration rate (GFR) calculated by Cockroft-Gault equation or MDRD formula, differed significantly between both groups (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Lower ribavirin biodisponibility in patients with HIV-HCV coinfection in comparison with HCV monoinfected patients

et al. 2014

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BackgroundIn HIV infected patients, the impact of ribavirin (RBV) pharmacology on sustained virologic response (SVR) to hepatitis C virus (HCV) treatment has not been fully investigated. The objective of this study was to compare the early RBV plasma exposure between a population of HIV-HCV coinfected patients and an HCV monoinfected group.MethodsEarly RBV plasma exposure (expressed as Area Under the Curve (AUC) from 0 to 4 h) after a 600 mg first dose of RBV was measured in a population of HIV-HCV coinfected patients in comparison with an HCV monoinfected group. Peripheral blood samples were collected before the 600 mg RBV first dose (T0) to ensure no detectable baseline plasma RBV, and then 30 mn, 1, 2 and 4 hours after RBV intake (T0.5, T1, T2 and T4).ResultsEighty-six patients with chronic hepatitis C entered the study among whom 23 (27%) were HIV-HCV coinfected. Coinfected patients had a significantly lower RBV-AUC 0-4h (median: 1469 μg*h/L [range 936–3677]) compared with monoinfected patients (2030 μg*h/L [851–7700]; p = 0.018). This RBV under exposure in coinfected patients persisted after normalization of AUC to RBV dose per kilogram of body weight (182 μg*h/L [110–425] versus 271 μg*h/L [82–1091], p = 0.001).ConclusionsThese results suggest that lower early bioavailability of RBV could be one of the reasons for lower SVR in HIV-HCV coinfected patients treated with pegylated interferon/RBV combination therapy. RBV plasma underexposure seems to be associated with the immunological status of the patients with lower AUC0-4h values observed in the more immunosuppressed coinfected patients.

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Section: Discussionmentioning

confidence: 99%