Clinical

Co-administration of ribavirin and stavudine safe in HIV patients with HCV

Last Updated: 2003-06-18 18:32:25 -0400 (Reuters Health)

NEW YORK (Reuters Health) - At least in the short term, there is no evidence that co-treatment with ribavirin and stavudine in HCV-HIV-co-infected patients has an adverse effect on plasma HIV levels, according to a recent report.

Previous reports have shown that ribavirin, in combination with interferon, is an effective treatment for hepatitis C in patients also infected with HIV (see Reuters Health story, May 23, 2000). However, there has been some evidence from laboratory studies that when given together ribavirin could diminish the efficacy of thymidine nucleoside analogues, such as stavudine and zidovudine.

Based on findings from observational studies, co-treatment with these agents does not adversely affect plasma HIV RNA levels. Still, until now, the interaction between these drugs has not been evaluated in a randomized trial, lead author Dr. Dominique Salmon-Ceron, from Hopitaux de Paris, and colleagues note.

Thirty HIV-HCV-co-infected patients were randomized to receive interferon-ribavirin or no HCV treatment for 3 months. All of the patients were treated with antiretroviral regimens that included stavudine for at least 3 months prior to enrollment.

Neither group experienced a significant change in plasma HIV RNA levels during the study period, the authors report in the May 15th issue of Clinical Infectious Diseases. There was a nonsignificant trend toward lower intracellular stavudine levels in the ribavirin group, but plasma levels of the drug were comparable in each group.

"This study has pointed out the lack of interaction between stavudine and ribavirin on HIV replication in vivo, which is reassuring for this coprescription in HIV-HCV-co-infected patients," the researchers state.

Clin Infect Dis 2003;36:1295-1304.