Influence of concomitant antiretroviral therapy on the rate of sustained virological response to pegylated interferon plus ribavirin in hepatitis C virus/HIV-coinfected patients

• Published in: Journal of antimicrobial chemotherapy Vol. 60; no. 6; pp. 1347 - 1354
• Main Authors: Pineda, Juan A., Mira, José A., Gil, Ignacio de los Santos, Valera-Bestard, Bárbara, Rivero, Antonio, Merino, Dolores, Girón-González, José A., Ríos-Villegas, María J., González-Serrano, Mercedes, Collado, Antonio, García-García, José A., Carrillo-Gómez, Raquel, López-Cortés, Luis F., Gómez-Mateos, Jesús
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.2007; Oxford Publishing Limited (England)
• Subjects: abacavir; Adult; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiviral Agents - therapeutic use; Biological and medical sciences; Biomedical research; Female; Hepacivirus - drug effects; Hepatitis; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - virology; Hepatitis C virus; HIV; HIV - drug effects; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - virology; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Interferon-alpha - administration & dosage; Interferon-alpha - therapeutic use; Male; Medical sciences; Medical treatment; Microbiology; Pharmacology. Drug treatments; Polyethylene Glycols - administration & dosage; Polyethylene Glycols - therapeutic use; Protease inhibitors; Recombinant Proteins; Reverse Transcriptase Inhibitors - therapeutic use; Ribavirin - therapeutic use; RNA, Viral - blood; stavudine; tenofovir; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; tenofovir; stavudine; abacavir; Purine nucleoside; Antiretroviral agent; RNA-directed DNA polymerase; Mixed infection; Hepatic disease; Nucleotide analog; Stavudine; Ribavirin; Tenofovir; Reverse transcriptase inhibitor; Nucleoside analog; Antiviral; Pegylated form; Pyrimidine nucleoside; Viral hepatitis C; Human; Immunopathology; Purine nucleotide; Drug combination; Acyclic nucleotide; Enzyme; Transferases; Cytokine; Enzyme inhibitor; AIDS; Organic phosphonate; Immune deficiency; Infection; Virus; Nucleotidyltransferases; Chemotherapy; Treatment; Dideoxynucleoside; Viral disease; Abacavir; Digestive diseases; Interferon; Flaviviridae; Inosine monophosphate dehydrogenase inhibitor; Hepatitis C virus; Hepacivirus
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkm373

Objectives To investigate whether concomitant antiretroviral therapy (ART) is a predictor of sustained virological response (SVR) in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with pegylated interferon plus ribavirin. Methods Three hundred and ten HIV/HCV-coinfected patients on pegylated interferon plus ribavirin treatment, 258 of them with concurrent ART, were included in this retrospective multicentre study. The predictors of SVR were evaluated. Results SVR was shown by 114 (37%) subjects. HCV genotype 2 or 3, plasma HCV-RNA load lower than 600 000 IU/mL, an exposure to the therapy against HCV infection ≥80% of the planned dose and baseline CD4 cell counts higher than or equal to 300/mm3 were predictors of SVR. Likewise, patients without ART and those receiving a combination including tenofovir or stavudine plus lamivudine plus a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) showed a higher SVR rate than the subjects who were on other ART strategies at baseline [44%, 44% and 29%, respectively; adjusted odd ratio (95% CI) for no ART = 1.96 (1.07–4.76), P = 0.025, and for ART including tenofovir or stavudine plus lamivudine plus a PI or a NNRTI = 2.08 (1.16–3.70), P = 0.014]. Conclusions The ART strategy on starting therapy with pegylated interferon plus ribavirin is a predictor of SVR in HIV/HCV-coinfected patients. Subjects without ART and those receiving combinations of a PI or a NNRTI with a nucleos(t)ide backbone of tenofovir or stavudine plus lamivudine respond better than those who receive other regimens.