Avaliação da efetividade do tratamento de pacientes co-infectados HCV-HIV com as terapias combinadas interferon + ribavirina e peginterferon + ribavirina.

Abstract

Acute C hepatitis becomes chronic in most cases. Part of these patients could progress to cirrhosis and develop complications such as: hypertensio, hepatic failure and hepatocellular carcinoma. HIV infection interferes and changes C hepatitis natural history. It is associated to higher levels of viremia and acceleration of the hepatic disease. The main goal of the treatment is to eraticate the virus, avoid the progression to cirrhosis and its complications. This study assess the treatment affectiveness in HIV/HCV co-infected patients using interferon + ribavirin and perginterferon + ribavirin protocols recommended by the Health Minister. The effectiveness ws measured by the HIV/HCV co-infected patients survival, mainly those who have the HCV genotypes 1, 2 e 3 submitted to combination therapy. The Markov model was performed in the review. The thesis present, through his chapters papers about chronic C hepatitis, HCV/HIV co-infectio, co-infected and C hepatitis stages treatment, elements manegement of hepatitis C treatment and the evaluation of the C hepatitis teratment effectiveness. The results shows higer effectiveness using peginterferon. Among genotype 1 patients treated with combined Therapy (peginterferon + ribavirin) 23,2% exibhited response. In genotypes 2 and 3, 49,7% shows response. The treatment with interferon + ribavirin received lower performance, 5,6% genotype 1 patients shows results and 16,2% of genotypes 2 and 3. The re-treatment with peginterferon + ribavirin of the non-responders and relapses presented the following data: 55,8% the response in genotypes 2 and 3 and 13,6% in genotype 1. The survaillance often 10 years of interferon + ribavirin patients was 38,3% for genotype 1 patients and 44,56% genotypes 2 and 3 patients. In perginterferon + ribavirin patients it was 48,58% in genotype 1 and 63,13% in genotypes 2 and 3. The survival rate of retreated patients with peginterferon + ribavirin was 47% genotype 1 patients and 68,17% for genotypes 2 and 3.