ANRS HC20 Effectiveness of an Optimized Anti HCV PegIFN-alpha2a + Ribavirin on Sustained Virological Response in Patients With HCV Genotype 1 and 4 Non Responders and Co-infected With HIV
ANRS HC20 Effectiveness of an Optimized Anti HCV PegIFN-alpha2a + Ribavirin on Sustained Virological Response in Patients With HCV Genotype 1 and 4 Non Responders and Co-infected With HIV
The purpose of this study is to assess the effectiveness of an optimized anti HCV treatment
 (360μg per week of PegIFN-alpha2a + 18mg/kg/j of Ribavirin for 6 months.
In patients HIV infected, the success rate do not exceed 20% in genotype 1 or 4 patients. In
 case of treatment failure , patients are rarely re-treated, and liver fibrosis progresses
 rapidly. The new molecules are not yet available for patients co-infected with HIV, and
 patients having already undergone a first treatment will likely be among the last to be
 included in trials evaluating the effectiveness of these treatments.

 However, recent studies show that it is possible to propose a new treatment "optimized" to
 these patients in the hope to obtain better success rate. Provide antiretroviral treatment,
 use of high doses of Peg-interferon and ribavrine, and supporting patients.
Inclusion Criteria:

 -  Age over 18 years

 -  Weight 85 kg below the pre-inclusion visit.

 -  Documented HIV infection (HIV positive)

 -  HCV infection documented by a positive PCR

 -  HCV Genotype 1 or 4

 -  Compensated liver disease (Child-Pugh below/equal to 6)

 -  Lymphocytes CD4 above 200/mm3

 -  Patient not answering a treatment for hepatitis C.

 -  Patient not covered by dual by Peg-IFN + riba for at least three months (wash out)

 Exclusion Criteria:

 -  Co-infection with HBV (HBsAg positive)

 -  Neutropenia below 1000/mm3

 -  Thrombocytopenia below 90000/mm3 or thrombocytosis over 500 000/mm3.

 -  Hemoglobin below 11 g / dL (men and women)

 -  Arguments radiological (ultrasound, CT or MRI) of hepatocellular carcinoma cell

 -  Antiretroviral containing didanosine (ddI) and stavudine (d4T) and zidovudine (AZT)
 and abacavir (ABC).