Pegylated interferon  2a plus ribavirin versus pegylated interferon  2b plus ribavirin for the treatment of chronic hepatitis C in HIV-infected patients

The two currently available types of pegylated interferon (peg-IFN) used to treat hepatitis C have different pharmacokinetic properties. It is unclear how these differences affect response to therapy. We compared the effectiveness and safety of peg-IFN-alpha 2a and peg-IFN-alpha 2b, both with ribavirin, against chronic hepatitis C virus (HCV) infection in HIV-infected patients. From the GESIDA HIV/HCV cohort, we analysed patients treated with peg-IFN-alpha 2a (n = 315) or peg-IFN-alpha 2b (n = 242). The primary endpoint was a sustained virological response (SVR). Both groups were well matched in baseline characteristics except for a higher frequency of injection drug users in the peg-IFN-alpha 2b group than in the peg-IFN-alpha 2a group (85% versus 76%; P = 0.01) and a higher frequency of bridging fibrosis and cirrhosis (F3-F4) in the peg-IFN-alpha 2b group than in the peg-IFN-alpha 2a group (42% versus 33%; P = 0.04). End-of-treatment response was significantly lower among patients treated with peg-IFN-alpha 2b [40% versus 52%; odds ratio (OR), 1.63; 95% confidence interval (95% CI), 1.16-2.29; P < 0.01]. However, no significant differences were found in SVR between patients treated with peg-IFN-alpha 2b and those treated with peg-IFN-alpha 2a (31% versus 33%; OR, 1.09; 95% CI, 0.75-1.59; P = 0.655). Therapy was interrupted due to adverse events in 33 (14%) patients treated with peg-IFN-alpha 2b and 47 (15%) patients treated with peg-IFN-alpha 2a. No differences in effectiveness and safety were found between peg-IFN-alpha 2b and peg-IFN-alpha 2a for the treatment of chronic HCV infection in HIV-infected patients.