INTERFERON-ALPHA TREATMENT OF CHRONIC HEPATITIS-C IN HIV-INFECTED PATIENTS RECEIVING ZIDOVUDINE - EFFICACY, TOLERANCE AND RESPONSE RELATED FACTORS

BACKGROUND/AIMS: In our area most of the human immunodeficiency virus (HIV) infected patients are intravenous drug users; HIV and hepatitis C virus infections often coexist in these patients, Due to the repercu ssions of both infections, we designed a trial to evaluate the efficac y, response-related factors and tolerance during an eight-month regime of recombinant interferon alpha-2b on hepatitis C virus infection. ME THODOLOGY: We included 79 patients in an open, prospective and multice ntric trial with zidovudine and interferon alpha-2b. Response to inter feron treatment was evaluated by biochemical and histopathological cri teria. RESULTS: A complete response (alanine aminotransferase normaliz ation) was obtained in 57.4% of patients. The significant response-rel ated factors were: degree of histopathological activity, CD4+ cell num ber and initial leukocyte number. CONCLUSIONS: Recombinant interferon therapy seems to be effective for chronic hepatitis C in HIV infected patients; the best response was in those with active chronic hepatitis and CD4+ cell counts greater than or equal to 200/mm(3), General tole rance was variable, although. side effects were not different from tho se seen in non-HIV patients. The most common side effect was flu-like syndrome (constitutional manifestations), with no interference on trea tment continuity; however, hematological toxicity prevents the indiscr iminate use of interferon.