NATURAL HISTORY-Hepatitis C Virus/ Human Immunodeficiency Virus Coinfection
NATURAL HISTORY-Hepatitis C Virus/ Human Immunodeficiency Virus Coinfection
The purpose of this study was to describe the time course and extent of hemoglobin (Hb)
 changes and the erythropoietic response to PEG-IFN/RBV (Pegylated Interferon and
 Ribavirin)-induced anemia In HCV(hepatitis C virus)/HIV (human immunodeficiency virus)
 co-Infected subjects.
Patients receiving combination therapy for chronic hepatitis C virus (HCV) infection
 (standard or pegylated interferon alfa [PEG-IFN] in combination with ribavirin [RBV])
 frequently develop moderate to severe anemia. In large, prospective, clinical trials of
 PEG-IFN alfa-2b and PEG-IFN alfa-2a, the reported mean decreases in hemoglobin (Hb) were 2.5
 g/dL, and 3.7 g/dL, respectively. Furthermore, in a retrospective study, 54% of standard
 interferon/RBV-treated patients had hemoglobin decreases of at least 3 g/dL. It is important
 to understand the causes, natural history, and risk factors associated with HCV
 therapy-induced anemia, because such decreases in hemoglobin can result in RBV dose reduction
 or discontinuation, which may decrease the likelihood of a virologic response by patient.
 Erythropoietin is an endogenous hormone that acts in the bone marrow to increase the number
 of erythroid progenitor cells (red blood cells). Normally, a decrease in the hemoglobin level
 is accompanied by an increase in the serum erythropoietin (sEPO) level, which will ultimately
 normalize the Hemoglobin level. The relationship between hemoglobin and serum erythropoietin
 is less apparent in patients with chronic diseases such as cancer and human immunodeficiency
 virus (HIV) infection. It is not known whether HCV/HIV co-infected patients receiving
 combination PEG-IFN/RBV therapy have a similarly diminished erythropoietic response to
 anemia. The objective of this study is to document the pattern of hemoglobin changes and
 erythropoietic response (from baseline to final assessment) in HCV/HIV co-infected patients
 receiving combination therapy with IFN / RBV. N/A
Inclusion Criteria:

 -  HIV- infected patients confirmed by HIV-RNA level

 -  HCV- infected patients confirmed by PCR(polymerase chain reaction) or branched DNA
 (b-DNA)

 -  Scheduled to commence combination IFN/RBV therapy on Day 1

 -  Normal serum creatinine

 -  On stable antiretroviral regimen (for HIV) for at least 4 weeks

 -  Life expectancy > 6 months

 Exclusion Criteria:

 -  Patients with history of any primary hematologic disease

 -  Anemia attributable to factors such as iron or folate deficiency, pre-treatment

 -  hemolysis or gastrointestinal bleeding

 -  Has suspected or confirmed significant hepatic disease from an etiology other than

 -  HCV (e.g. alcohol, HBV DNA, autoimmune disease etc)