Soriano V, García-Samaniego J, Bravo R, González J, Castro A, Martńez-Odriozola P, Colmenero M, Carballo E, Suárez D, Castilla J, Rodriguez-Piñero F J, Moreno A, del Romero J, Pedreira J, González-Lahoz J
Centro de Investigaciones Clínicas, Instituto de Salud Carlos III, Madrid.
Med Clin (Barc). 1996 Apr 6;106(13):486-90.
Alfa-interferon (aIFN) is widely recommended for the treatment of chronic hepatitis C (CHC). Hepatitis C virus (HCV) infection is very common in injecting drug users (IDUs), which in Spain represent the large number of HIV-infected persons. Interaction between human immunodeficiency virus (HIV) and HCV in coinfected patients might accelerate the clinical course of HCV-associated liver disease. The efficacy and safety of aIFN therapy in HIV-infected patients with CHC is not well known.
In a multicenter, prospective, open, non randomized and partially controlled study, we compared the efficacy and safety of aIFN therapy in 119 patients with CHC, of whom 90 were HIV-positive and 29 HIV-negative. Interferon was started at 5 mega U tiw for 3 months, followed in responders by 3 megaU tiw for additional 9 months.
One hundred seven patients completed the study. A normalization of the aminotransferase values at the end of treatment (complete response, CR) was observed in 26/80 (32.5%) HIV-positive and 10/27 (37.0%) HIV-negative individuals (p = 0.666). Relapses at 12 months of stopping aIFN were seen in 30.8% of HIV-positive subjects and 12.5% of HIV-negatives (p = 0.403). Side effects were uncommon and did not have severity; only one patient required to stop the medication. However, 3 HIV-positive subjects treated with aIFN (3.5% of them) showed an irreversible fall of CD4+ T-cells below half the baseline values.
HIV-infected patients with CHC seems to respond to aIFN with a similar rate than HIV-negatives. Moreover, the drug is similarly well tolerated in both groups of patients, although a fall of CD4+ T-cells is an unusual side effect of particular relevance observed in HIV-infected patients.
α干扰素（aIFN）被广泛推荐用于治疗慢性丙型肝炎（CHC）。丙型肝炎病毒（HCV）感染在注射吸毒者（IDU）中非常常见，在西班牙，这部分人群占大量HIV感染者。合并感染患者中人类免疫缺陷病毒（HIV）与HCV之间的相互作用可能会加速HCV相关肝病的临床进程。aIFN治疗HIV感染的CHC患者的疗效和安全性尚不清楚。
在一项多中心、前瞻性、开放性、非随机且部分对照的研究中，我们比较了aIFN治疗119例CHC患者的疗效和安全性，其中90例为HIV阳性，29例为HIV阴性。干扰素起始剂量为5百万单位，每周3次，持续3个月，治疗有反应者随后以3百万单位，每周3次，再持续9个月。
107例患者完成了研究。在治疗结束时，80例HIV阳性患者中有26例（32.5%）和27例HIV阴性患者中有10例（37.0%）观察到转氨酶值正常化（完全缓解，CR）（p = 0.666）。停止使用aIFN 12个月时，HIV阳性受试者中有30.8%复发，HIV阴性受试者中有12.5%复发（p = 0.403）。副作用不常见且不严重；只有1例患者需要停药。然而，3例接受aIFN治疗的HIV阳性受试者（占3.5%）出现CD4 + T细胞不可逆下降至低于基线值的一半。
HIV感染的CHC患者对aIFN的反应率似乎与HIV阴性患者相似。此外，两组患者对该药物的耐受性相似，尽管CD4 + T细胞下降是在HIV感染患者中观察到的一种特殊且罕见的副作用。
