Pegylated interferon-alpha monotherapy leads to low response rates in HIV-infected patients with acute hepatitis C

Background: Despite a rising incidence of acute HCV in patients infected with HIV, the optimal therapeutic strategy (pegylated interferon-alpha [PEG-IFN-alpha] monotherapy or in combination with ribavirin) is still under debate. Methods: A total of 23 HIV-infected patients were prospectively diagnosed with acute HCV and treated with PEG-IFN-alpha 2a monotherapy (180 mu g/week) for 24 or 48 weeks. Add-on ribavirin was allowed from week 4 of therapy onwards. There were three patients who were not included for different reasons. Blood samples were routinely drawn for viral load measurement and IL28B polymorphism analysis. Results: Spontaneous viral clearance occurred in 1 (4%) patient. Nineteen patients (13 genotype 1 and 6 genotype 4) received treatment with PEG-IFN-alpha monotherapy (3 with add-on ribavirin) resulting in a rapid virological response (HCV RNA Conclusions: PEG-IFN-alpha monotherapy resulted in a low SVR rate and a high percentage of null-response, whereas non-SVR was associated with a polymorphism in the IL28B gene (rs8099917).