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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000073
Brief Report: Clinical Science

Pilot Study of Pioglitazone Before HCV Retreatment in HIV/HCV Genotype 1–Infected Subjects With Insulin Resistance and Previous Nonresponse to Peginterferon and Ribavirin Therapy: A5239

Marks, Kristen M. MD, MS*; Kitch, Douglas MS; Chung, Raymond T. MD; Hadigan, Colleen MD, MPH§; Andersen, Janet ScD; Tien, Phyllis MD‖,¶; Luetkemeyer, Annie MD#; Alston-Smith, Beverly MD§; Glesby, Marshall J. MD, PhD*; the A5239 Team

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Abstract

Abstract: Insulin resistance is associated with nonresponse to hepatitis C virus (HCV) treatment. In this multicenter, single-arm pilot study, adult, HIV/HCV genotype 1–coinfected previous nonresponders to peginterferon/ribavirin (PegIFN/RBV) with homeostatic model assessment of insulin resistance >2.5 were treated with pioglitazone (PIO) for 24 weeks followed by PegIFN/RBV/PIO. Three of 19 subjects (15.8%) achieved undetectable HCV RNA at week 24 of PegIFN/RBV/PIO, which was not significantly different than the historical null rate of 10% (P = 0.29, lower limit of the exact 1-sided 90% confidence interval 5.9%). Over the 24 weeks of PIO monotherapy, alanine aminotransferase and aspartate aminotransferase declined significantly and correlated with improved metabolic parameters.

© 2014 by Lippincott Williams & Wilkins

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