RESUMEN
The efficacy and tolerance of telaprevir (TVR) was examined in 20 mostly cirrhotic HIV-hepatitis C genotype 1 (HCV-G1)-infected patients failing previous treatment with pegylated-interferon and ribavirin (PR). HCV-RNA less than 12âIU/ml was observed in 35.3% of patients at W2, 55.0% at W4, 65.0% at W12 and 55.0% at W24. All patients with virological failure (nâ=â9) exhibited V36M/R155K mutations. Early virological response was a determinant of HCV-RNA less than 12âIU/ml at W24 (Pâ<â0.001). No grade 3-4 dermatological side-effects were reported. TVR-PR tritherapy appeared to be rather effective and well tolerated among difficult-to-treat HIV-HCV-G1 patients.
Asunto(s)
Antivirales/administración & dosificación , Infecciones por VIH/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/administración & dosificación , Oligopéptidos/administración & dosificación , Polietilenglicoles/administración & dosificación , Antivirales/uso terapéutico , Coinfección , Infecciones por VIH/complicaciones , Hepacivirus/genética , Hepatitis C Crónica/complicaciones , Humanos , Interferón-alfa/efectos adversos , Oligopéptidos/efectos adversos , Polietilenglicoles/efectos adversos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Multiple hepatitis co-infections are frequent in HIV-infected patients, often resulting in severe liver diseases that are difficult to treat. We report here the complete resolution of a chronic hepatitis B and D co-infection in a patient who was also infected with HCV and HIV. This cure was observed after 24weeks of combination therapy associating pegylated-IFN and ribavirin, which was initially given to treat HCV. An unexpected and extensive HDV replication was observed in this patient after HBs Ag had cleared from the serum, which was followed by a stable halt in HDV replication. Implications of this unusual observation will be discussed.