Using phosphazide in regimes of ART in patients co-infected with HIV and HCV receiving treatment of hepatitis

Purpose: Comparing of the efficacy and safety of treatment of chronic hepatitis C PegIFN and RBV in HIV-infected patients receiving HAART with phosphazide (PhAZT) or abacavir (ABC). Methods: 81 co-infected with HIV/HCV patients with ART >3 months, treated by PegIFN and RBV (1000-1200 mg/day by weight) during 24-48 weeks. 50 patients (group 1) received PhAZT+3TC+EFV or PIs, and 31 patients (group 2) - ABC+3TC+EFV or PIs. Patients in both groups did not differ by sex, age, stage of HIV infection, body mass index, HCV genotype, HCV RNA levels, the degree of hepatic fibrosis. Results: Virologic response EOT in 1st group was 74% (genotype 1 - 56%, genotype 3 - 92%), in 2nd group - 75.9% (genotype 1 - 61.5%; genotype 3 - 87.5%). Sustained virological response (SVR) in 1st group was 62% (genotype 1 - 44%, genotype 3 - 80%), and in 2nd group - 53.3% (genotype 1 - 46.7%, genotype 3 - 60%). Relapse of HCV replication within 24 wks after therapy was observed in 12% of pts with 1st group and 22.6% - 2nd group (p<0.05). The frequency of relapse in pts with G1 was 12% and 14.8%, with G3 - 12% and 27.5% (in 1st and 2nd groups, p<0.05). If the duration of HCV therapy was <48 wks, SVR rates in pts of both groups was 50% and 41.1%, and if 48 wks and more - 73.1% and 71.4%, respectively (p<0.05). When using PIs - SVR was 52% and 57% in 1st and 2nd groups. In appointing EFV SVR in 1st group - 76.2% (genotype 1 - 70%, genotype 3 - 81.8%), in 2nd group - 50% (genotype 1 - 44.4%, genotype 3 - 57.1%), p<0.05. Inclusion in the regime of HAART PhAZT had no significant effect on the performance of peripheral blood. Decreased hemoglobin, neutrophil and platelet counts were similar in both groups and no more than 1-2 degrees of toxicity. Reducing the CD4+ count during HCV treatment has been less pronounced when using PhAZT (compared with ABC) in combination with EFV, and with PI. Conclusions: PegIFN and RBV therapy in pts with HIV/HCV co-infection receiving HAART, is effective in 44-47% (genotype 1) and 60-80% (genotype 3). Application of the regime PhAZT+3TC+EFV was safe and allowed to reach the maximum frequency of SVR - 76.2%. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Kravchenko A et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18430 http://www.jiasociety.org/index.php/jias/article/view/18430 | http://dx.doi.org/10.7448/IAS.15.6.18430