Histological response to pegIFNα-2a (40KD) plus ribavirin in HIV-hepatitis C virus co-infection

Objective: Paired liver biopsies from patients enrolled in the multinational AIDS PEGASYS Ribavirin International Co-infection Trial were analysed to investigate a possible correlation between virological and histological responses. Design and methods: A total of 860 HIV-hepatitis C virus (HCV)-co-infected patients were randomly assigned to receive pegIFN alpha-2a (40KD) 180 mu g/week plus 800 mg daily ribavirin, pegIFNa-2a (40KD) plus placebo or conventional IFN alpha-2a 3 MIU three times a week plus ribavirin for 48 weeks. Paired biopsies were obtained from 401 patients and scored locally using the Ishak-modified histological activity index (HAI). The second biopsy was obtained, on average, 26 weeks or more after the end of treatment. Histological response was defined as a 2-point or greater reduction in the HAI score. Conclusion: The histological response rate was significantly higher in HIV-HCV-co-infected patients who received pegIFN alpha-2a (40KD) plus ribavirin than in those receiving pegIFN alpha-2a (40KD) plus placebo or IFN alpha-2a plus ribavirin. Histological response was correlated with virological response, although a substantial proportion of patients who did not achieve an SVR experienced histological improvement. Conclusion: The histological response rate was significantly higher in HIV-HCVco-infected patients who received pegIFN alpha-2a (40KD) plus ribavirin than in those receiving pegIFN alpha-2a (40KD) plus placebo or IFN alpha-2a plus ribavirin. Histological response was correlated with virological response, although a substantial proportion of patients who did not achieve an SVR experienced histological improvement.