Clinical experience with pegylated interferon α-2A plus ribavirin for chronic hepatitis C virus infection in patients infected with HIV: The APRICOT study

Currently, pegylated interfered α (PEG-IFN α) plus ribavirin (RBV) is the standard of care for the treatment of chronic hepatitis C virus (HCV) monoinfection. Evidence from several randomized clinical studies indicates that this combination provides superior virologic efficacy and comparable tolerability to standard IFN α plus RBV regimens in patients coinfected with human immunodeficiency virus (HIV)/HCV. The AIDS Pegasys Ribavirin International Coinfection Trial (APRICOT) study is the largest international, randomized, placebo-controlled study to examine the efficacy and safety of combination therapy with PEG-IFN α-2a plus RBV in patients coinfected with HIV/HCV. In the APRICOT study, the overall rate of sustained virologic response among patients treated with PEG-IFN α-2a plus RBV was 40%, compared to 12% for those patients treated with IFN α-2a plus RBV, considerably higher than reported in other recent trials of this combination in patients coinfected with HIV/HCV. These results indicate that PEG-IFN α-2a plus RBV is superior to standard IFN α-2a plus RBV for treating chronic HCV in patients coinfected with HIV. Pharmacokinetic analysis indicates that RBV had no effect on intracellular levels of lamivudine, stavudine, or zidovudine and does not appear to modify the plasma concentration-time profile of these agents in coinfected patients.