Adverse Effects of HCV Therapy More Common in HIV-Infected Women

By Will Boggs, MD

NEW YORK (Reuters Health) Aug 05 - Women with HIV have higher rates of adverse events from treatment for hepatitis C virus (HCV) compared to men with HIV, researchers reported online July 8th in the Journal of Acquired Immune Deficiency Syndromes.

"Our study did not demonstrate that any particular side effect occurred more commonly in women than in men. Rather, physicians should be aware that HIV-infected women have a greater chance of developing side effects overall during interferon-based and ribavirin HCV therapy and that antiretroviral regimens during therapy may play a role in the development of these side effects," said lead author Dr. Debika Bhattacharya from the University of California, Los Angeles, in e-mail to Reuters Health.

The findings are from a meta-analysis of 3 trials involving 1376 subjects, including 288 women (21% women).

According to Dr. Bhattacharya and colleagues, adverse events requiring treatment discontinuation occurred in 24% of women vs 16% of men. Nearly two-thirds of women (61%) had adverse events requiring treatment modification, compared to less than half of men (48%).

Women on regimens containing non-nucleoside reverse transcription inhibitors were more likely to have adverse events requiring treatment discontinuation than antiretroviral therapy-na�ve women or women on other antiretroviral regimens. This association was not observed in men.

In contrast, antiretroviral therapy-na�ve women were more likely to have an adverse event requiring treatment modification. The opposite was true in men: those who had never taken antiretrovirals were less likely to have adverse events requiring treatment modification.

Women were 54% more likely than men to discontinue therapy and 43% more likely to require treatment modification as a result of adverse events.

Furthermore, the median time to an adverse event requiring treatment modification was 24 weeks in women vs 48 weeks in men.

There was no gender difference in the types of adverse events that occurred, however.

"This work highlights the importance of examining sex differences in the clinical outcomes of HCV therapy in HIV infection," Dr. Bhattacharya concluded. "These differences should be further investigated."

Also, the researchers say, HIV/HCV coinfection studies should consider the possibility that antiretroviral regimens might figure importantly in women's risks for adverse events during HCV therapy.

SOURCE: http://link.reuters.com/fuw53n

J Acquir Immune Defic Syndr 2010.

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