A PILOT-STUDY ON THE EFFICACY OF ESCALATING DOSAGE OF ALPHA-INTERFERON FOR CHRONIC HEPATITIS-C IN HIV-INFECTED PATIENTS

Chronic liver disease caused by hepatitis C virus (HCV) seems to prese nt a more accelerated course in HIV-infected patients, leading to cirr hosis and liver failure in a shorter period of time than in HIV-negati ve individuals. As efforts to increase life expectancy in HIV-infected people progress, substantial morbidity and mortality from HCV infecti on is likely to arise amongst subjects infected parenterally, such as injecting drug users, haemophiliacs and transfusion recipients, Prelim inary results have suggested that alpha-interferon (IFN) treatment all ows higher rates of response in HIV-infected patients with higher CD4 lymphocyte counts, suggesting a primary dependence of IFN on a preser ved immune system in order to act appropriately, In an open, multicent re, prospective trial we analysed whether the use of larger doses of I FN, through an escalating schedule, might overcome the limits imposed by immune dysfunction, An interim analysis performed in 29 patients co ncluded that escalating the dosage did not improve the rate of respons e to IFN, In fact, only one (8.3%) out of 12 patients without response after 3 months of being on IFN therapy achieved response after the do sage was increased from 5 MU to 8 MU sc three times a week, Moreover, he relapsed 3 months after completion of treatment for 1 year.