Nitazoxanide Plus Ribavirin and Peginterferon for Therapy of Treatment Naive HCV Genotype 1 and HIV Coinfected Subjects

Inclusion Criteria

• HIV-1 infection
• Documentation of hepatitis C virus (HCV) genotype 1 infection prior to entry
• Chronic HCV infection for at least 180 days
• CD4+ cell count greater than 200 cells/mm3 obtained within 90 days prior to study entry
• Detectable HCV viral load obtained within 90 days prior to study entry
• Any change in antiretroviral (ARV) regimen, including initiation of antiretroviral therapy (ART), a switch in ART regimen, or a discontinuation of ART, had to have occurred more than 60 days prior to study entry. Breaks in therapy for a maximum of 14 days total during the 60-day period were allowed. Participants not on ART should have had no plans to initiate therapy during the first 24 weeks after study entry. Participants who did start ART did not have to discontinue study treatment. Participants on ART should have planned to remain on the same therapy for at least 12 weeks after study entry. Changes in formulation or dosage were permitted.
• Certain laboratory values obtained within 42 days prior to study entry
• Agreement to use contraception, if participating in sexual activity that could lead to pregnancy, for the duration of study and for 6 months afterward
• Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase less than or equal to five times the upper limit of normal (ULN)
• Hemoglobin >=11 g/dl for men and >=10 g/dl for women

Exclusion Criteria

• Use of the ARV didanosine (ddI)
• Receipt of any interferon
• Receipt of any therapy for HCV, including ribavirin (RBV) or experimental treatment
• Decompensated cirrhosis
• Currently active or other known causes of significant liver disease, including chronic or acute hepatitis B, acute hepatitis A, hemochromatosis, or homozygous alpha-1 antitrypsin deficiency
• Pregnancy or breastfeeding
• Men with pregnant sexual partners or men planning pregnancy with any sexual partner during treatment or for 24 weeks after treatment completion
• Uncontrolled or active depression, other psychiatric disorder, or any hospitalization within the past 52 weeks that, in the opinion of the site investigator, would prevent participation
• Prior suicide attempt
• Active thyroid disease (use of thyroid hormone replacement therapy permitted if thyroid stimulating hormone [TSH] or free thyroxine [T4] in the normal range)
• History of autoimmune processes, including Crohn's disease, ulcerative colitis, severe psoriasis, or rheumatoid arthritis, that may be exacerbated by interferon use
• Systemic antineoplastic or immunomodulatory treatment or radiation within 24 weeks prior to study entry
• Serious illness, including malignancy or active coronary artery disease, within 24 weeks prior to study entry
• Chronic medical condition that, in the site investigator's opinion, might preclude completion of the protocol
• Presence of acute or active opportunistic infections within 24 weeks prior to study entry
• Evidence of hepatocellular carcinoma (HCC) or alpha-fetoprotein level of greater than 50 ng/ml unless an imaging procedure (e.g., computed tomography [CT] scan or magnetic resonance imaging [MRI]) showed no evidence of a hepatic tumor. Each may have been obtained up to 24 weeks before study entry.
• History of hemoglobinopathy (e.g., thalassemia) or any other cause of or tendency toward hemolysis
• History of major organ transplantation with an existing functional graft
• Known allergy, sensitivity, or any hypersensitivity to components of study drugs or their formulations
• Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements