Background:  We have previously reported sustained virological response rates of 75% for 45 HIV/hepatitis C virus (HCV) -co-infected patients treated with 24 weeks of full, weight-adjusted doses of pegylated interferon (pegIFN) and ribavirin (RBV) for genotype 2/3 disease. We now present further evidence of high sustained virological response rates in genotype 2/3 disease in co-infected patients treated for 24 weeks.

Methods:  We treated 73 patients co-infected with HIV/HCV with full, weight-adjusted doses of pegIFN and RBV for 24 to 48 weeks depending on HCV genotype. Patients with genotype 2/3 disease received 24 weeks of treatment and genotype 1/4 48 weeks. Virological response was assessed at weeks 4, 12, 24, and end of treatment and at 12 and 24 weeks post-end-of-treatment. Primary end point was undetectable HCV RNA at 24 weeks post completion of therapy (sustained virological response).

Results:  Of our 73 patients, 86% were male, 57% were on ART, average CD4 count at entry was 500 (1219 to155), 32 were infected with genotype 1/4 and 41 with genotype 2/3 disease. In an intention-to-treat analysis, 53% had a sustained virological response, (31% genotype 1/4 and 70% genotype 2/3). On treatment, analysis revealed a sustained virological response of 62% (37% genotype 1/4, 79% genotype 2/3). All of the patients who had undetectable HCV RNA at week 4 (very early virological response) had a sustained virological response; 8 patients discontinued treatment early due to side effects; and 7 are currently still undergoing treatment.

Conclusions:  This study provides further evidence for individualising HCV treatment duration for HIV/HCV-co-infected patients with genotype 2/3 disease who receive full-dose pegIFN and RBV and are guided by very early virological response. The findings strengthen the argument for targeted treatment durations in HIV/HCV-co-infected patients.