The aim of this study is to prove the efficacy of peginterferon in HIV infected patients with liver disease caused by hepatitis C virus (HCV) when the treatment to eradicate the virus failed. This scientific proof needs a comparative study to be done including two groups of patients randomly allocated: one with the treatment (peginterferon) and the other without any treatment against HCV with a duration of 2 years. To conclude, two liver biopsies are needed; one before the study and a second 2 years after.
C hepatitis in HIV infected patient becomes a major issue although the survival of patients, has improved in the last decades regarding to the advent of HAART, the mortality related to liver disease has increased in this population. Sustained virological response for HCV can be obtained with peg-interferon and ribavirin treatment but more or less 50% of patients experienced failure to this treatment and liver fibrosis due to HCV infection progress and may lead to cirrhosis and hepato-carcinoma. To demonstrate the efficacy of peginterferon therapy to reduce the liver damage causes by HCV infection, a randomised controlled study is needed comparing one group of patient treated by peginterferon and one group without any treatment against HCV infection. In order to show 30% difference between the two groups in reducing one point of fibrosis score (METAVIR scale), 150 patients are needed. The duration of the study is 96 weeks
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
52
Peg-Interferon Alpha2a by subcutaneous injection, 180µg, once weekly
Ribavirin: tablet oral, weight-based dose, 1000 mg for subjects weighing below 75 kg or 1200 mg for subjects weighing equal or over 75 kg, once daily
All antiretroviral drugs are allowed, their choice being left to the discretion of the investigator. Particular attention will be carried to the patients with antiretroviral susceptible to cause a cumulative toxicity with anti-VHC drugs
All antiretroviral drugs are allowed, their choice being left to the discretion of the investigator. Particular attention will be carried to the patients with antiretroviral susceptible to cause a cumulative toxicity with anti-VHC drugs
Service de Maladies Infectieuses et de Réanimation Médicale
Rennes, France
Percentage of patients who experienced one point decreases of their fibrosis histological score (Metavir).
Time frame: Week 96
Distribution of the change of fibrosis Metavir score in each group
Time frame: Week 96
Distribution of fibrosis score from Chevallier classification
Time frame: Week 96
Plasmatic fibrosis markers dosages
Time frame: Week 96
Viral load quantification for HIV and HCV
Time frame: Week 96
Number and percentage of CD4/CD8 cell count throughout the study
Time frame: Day 0 to week 96
Number and percentage of patient had more thand 200 copies/ml throughout the study
Time frame: Day 0 to week 96
Occurrence of hepatic complication related to HCV
Time frame: Day0 to week 96
Survival throughout the study
Time frame: Day 0 to week 96
Quality of life questionnaire
Time frame: Day 0 to week 96
Fibrotest (plasmatic fibrosis marker)
Time frame: Day 0, week 48 and week 96
Histological improvement according to the total interferon dose received
Time frame: Day 0 to week 96
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