Efficacy of and risk of bleeding during pegylated interferon plus ribavirin treatment in HIV/HCV-coinfected patients with pretreatment thrombocytopenia

• Published in: European journal of clinical microbiology & infectious diseases Vol. 34; no. 9; pp. 1879 - 1884
• Main Authors: Mira, J. A., Neukam, K., López-Cortés, L. F., Rivero-Juárez, A., Téllez, F., Girón-González, J. A., de los Santos-Gil, I., Ojeda-Burgos, G., Merino, D., Ríos-Villegas, M. J., Collado, A., Torres-Cornejo, A., Macías, J., Rivero, A., Pérez-Pérez, M., Pineda, J. A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2015; Springer Nature B.V
• Subjects: Adult; Antiviral Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Blood platelets; Cohort Studies; Coinfection - virology; Drug Therapy, Combination; Esophageal and Gastric Varices - pathology; Female; Gastrointestinal Hemorrhage - pathology; Hepacivirus - drug effects; Hepatitis C; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - virology; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - drug effects; Human immunodeficiency virus; Humans; Interferon; Interferon-alpha - therapeutic use; Internal Medicine; Liver cirrhosis; Male; Medical Microbiology; Middle Aged; Platelet Count; Polyethylene Glycols - therapeutic use; Prospective Studies; Recombinant Proteins - therapeutic use; Ribavirin - therapeutic use; Risk; Spain; Thrombocytopenia; Thrombocytopenia - complications; Treatment Outcome; Viral Load; Spain; Romiplostim; Eltrombopag; Sustained Virologic Response; Sustained Virologic Response Rate; Liver Stiffness
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-015-2426-6

The aim of this study was to assess the efficacy of and the risk of major bleeding during pegylated interferon (peg-IFN)/ribavirin (RBV) treatment among human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients according to the pretreatment platelet count. Two hundred and seventy-four HCV/HIV-coinfected, previously naïve individuals with compensated cirrhosis enrolled in one Spanish prospective cohort who received peg-IFN/RBV were included in this study. The frequency of severe bleeding and sustained virological response (SVR) rate were compared between patients with a pretreatment platelet count ≤70,000/mm
3
and >70,000/mm
3
, respectively. Sixty-one (22 %) patients had a baseline platelet count ≤70,000/mm
3
. The median (Q1–Q3) pretreatment platelet count was 58,000 (49,000–65,000) cells/mm
3
in the platelet ≤70,000 group and 129,000 (102,500–166,000) cells/mm
3
in the platelet >70,000 group (
p
 < 0.0001). Seventeen (28 %) subjects of the platelet ≤70,000 group and 71 (33 %) patients of the platelet >70,000 group achieved SVR (
p
 = 0.4). Only 2 (3.2 %) patients in the platelet ≤70,000 group developed a severe hemorrhagic event, specifically esophageal variceal bleeding. The efficacy of therapy with peg-IFN/RBV in HIV/HCV-coinfected patients with low pretreatment platelet counts is comparable to that found in the overall subset of subjects with compensated cirrhosis. The frequency of severe hemorrhagic events related with this therapy is low in this population.