Drug mix helps those with hepatitis C, HIV

A new drug combination can do a much better job guarding against liver damage caused by hepatitis C than previous therapy in people also infected with HIV, the AIDS virus, according to two studies released Wednesday.

Like HIV, hepatitis C is spread by infected body fluids and has become a major problem for people with the AIDS virus. About 300,000 people with HIV in the United States also have hepatitis C.

“Hepatitis C has become the new opportunistic infection among HIV-infected patients,” said Raymond Chung of Massachusetts General Hospital and the leader of one of the studies published in Thursday’s edition of The New England Journal of Medicine.

Until now, the standard treatment for hepatitis C -- interferon and ribavirin -- has been much less effective in people also infected with HIV. In fact, patients with both viruses who tried the standard treatment often stopped therapy because they suffered more pronounced side effects.

The two studies looked at therapy for both viruses using a chemically modified form of interferon, a synthetic version of a natural immune system protein. The new form, known as peginterferon, stays active in the body for a longer period of time.

One weekly injection
Both studies compared peginterferon with the established treatment, which uses three-times-per-week injections of regular interferon. Peginterferon requires just one weekly injection.

In Chung’s study, 27 percent of patients taking interferon kept the virus at bay versus 12 percent of volunteers getting the older treatment.

In a larger experiment, involving 95 medical centers in 19 countries, just 12 percent of the 289 volunteers with both hepatitis C and HIV had all traces of the hepatitis C virus disappear using the older form of interferon plus ribavirin.

In contrast, virus levels became undetectable in a fifth of the 286 patients treated with peginterferon alone. The success rate rose to 40 percent when peginterferon and ribavirin were combined.

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Roche, which sells peginterferon under the brand name Pegasys, paid for the larger study. Schering-Plough Corp. also sells the drug under the brand name Peg-Intron.

Douglas Dieterich, of the Mount Sinai School of Medicine in New York and a co-author of the larger study, called the results “groundbreaking news” for the hundreds of thousands of Americans living with both viruses.

Another piece of good news from the studies: the interferon treatments did not seem to interfere with the AIDS drugs the volunteers were receiving.

In both studies, however, the success rate depended on the type of hepatitis C the patient was carrying.

For example, among patients in the larger study with genotype 1 hepatitis, which is traditionally harder to treat, the combination of peginterferon and ribavirin eliminated hepatitis C virus particles from the blood in 29 percent of the volunteers. But for patients with genotypes 2 and 3, the success rate was 62 percent.