Reuters Health Information (2005-03-04): Interleukin-2 does not improve standard HCV treatment in HIV patients
Interleukin-2 does not improve standard HCV treatment in HIV patients
Last Updated: 2005-03-04 15:11:03 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Although it does not
increase toxicity, interleukin-2 (IL-2) does not improve the efficacy
of standard treatment for hepatitis C virus (HCV) infection in patients
coinfected with HIV, according to a report in the March 1st issue of
The Journal of Infectious Diseases.
"There remains a great need to optimize treatment of HCV
coinfection," Dr. Marshall J. Glesby from Weill Medical College of
Cornell University, New York told Reuters Health. "Unfortunately,
combining low dose IL-2 plus standard HCV therapy does not appear to be
a promising approach for this patient population."
Dr. Glesby and colleagues investigated the safety and effectiveness
of combining IL-2 with pegylated interferon-alpha-2b and ribavirin for
HCV coinfection in 23 HIV-positive patients.
More than a quarter of the subjects (6) discontinued therapy before
week 24 of the 84 week study, the report indicates, and nearly half
(11) discontinued therapy before study completion.
Most patients (18) reported at least a grade 2 symptom during
follow-up, the authors report, with the first such adverse effect
arising a median 4 weeks into the study.
Only 5 of the patients had HCV-RNA levels below the level of
quantification by the end of specific anti-HCV treatment, the
researchers note, and only 4 patients had sustained virologic
responses. At weeks 72 and 84, 18% of patients had achieved at least a
2-log10 decrease from baseline in HCV-RNA level.
Only a third of the patients had normal ALT levels at week 84, the
investigators report, and only 4 subjects (17%) had both biochemical
and virologic responses at week 84.
"The fact that there were no major liver toxicities in this study is
encouraging," Dr. Glesby said, "since there was concern at the outset
that stimulating the immune system through IL-2 use could exacerbate
the inflammatory response in the liver and result in liver injury."
"For co-infected patients who are candidates for therapy, treatment
with pegylated interferon plus ribavirin remains the gold standard
treatment just as it is for HCV monoinfected patients," Dr. Glesby
"Ongoing research efforts by the AIDS Clinical Trials Group and
other research groups will hopefully result in more effective therapy
for co-infection in the coming years," Dr. Glesby added.
J Infect Dis 2005; 191:686-693.