In HIV/HCV-Coinfected Patients, Should Ribavirin Dosing Be Weight-Based?

A randomized study suggests that weight-based dosing is not better than using a fixed dose, but controversy persists.

In hepatitis C virus (HCV) genotype 1–monoinfected patients who receive pegylated interferon plus ribavirin, sustained virologic response (SVR) rates are significantly better with weight-based dosing (WBD) of ribavirin than with fixed lower doses of the drug. However, some of the first large trials involving HIV/HCV-coinfected patients used fixed-dose (FD) ribavirin because of concerns about toxicity and drug interactions. To assess the optimal dose of ribavirin in coinfected patients, investigators conducted a double-blind trial — “PARADIGM” — at multiple sites in the U.S., Portugal, and Spain. The trial occurred before the era of HCV direct-acting antivirals.

A total of 410 HIV/HCV genotype 1–coinfected patients received 48 weeks of pegint…

Reviewing Author

Rajesh T. Gandhi, MD

In HIV/HCV-Coinfected Patients, Should Ribavirin Dosing Be Weight-Based?

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Reviewing Author