Efficacy of pegylated interferon plus ribavirin treatment in HIV/hepatitis C virus co-infected patients receiving abacavir plus lamivudine or tenofovir plus either lamivudine or emtricitabine as nucleoside analogue backbone

• Published in: Journal of antimicrobial chemotherapy Vol. 62; no. 6; pp. 1365 - 1373
• Main Authors: Mira, José A., López-Cortés, Luis F., Barreiro, Pablo, Tural, Cristina, Torres-Tortosa, Manuel, de los Santos Gil, Ignacio, Martín-Rico, Patricia, Ríos-Villegas, María J., Hernández-Burruezo, José Juan, Merino, Dolores, López-Ruz, Miguel Ángel, Rivero, Antonio, Muñoz, Leopoldo, González-Serrano, Mercedes, Collado, Antonio, Macías, Juan, Viciana, Pompeyo, Soriano, Vincent, Pineda, Juan A.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.12.2008; Oxford Publishing Limited (England)
• Subjects: Adenine - analogs & derivatives; Adenine - therapeutic use; Adult; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; antiretroviral therapy; Antiviral agents; Biological and medical sciences; Blood - virology; Cohort Studies; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Dideoxynucleosides - therapeutic use; Emtricitabine; Female; Follow-Up Studies; HCV genotype; Hepacivirus - isolation & purification; Hepatitis; Hepatitis C virus; Hepatitis C, Chronic - drug therapy; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV-1 - isolation & purification; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Inhibitor drugs; Interferon; Interferon-alpha - therapeutic use; Lamivudine - therapeutic use; Male; Medical sciences; Middle Aged; Multivariate Analysis; Organophosphonates - therapeutic use; Pharmacology; Pharmacology. Drug treatments; Polyethylene Glycols; Recombinant Proteins; Ribavirin - therapeutic use; sustained virological response; Tenofovir; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Viral Load; antiretroviral therapy; sustained virological response; HCV genotype; Purine nucleoside; Antiretroviral agent; Mixed infection; Hepatic disease; Nucleotide analog; Ribavirin; Tenofovir; Reverse transcriptase inhibitor; Nucleoside analog; Antiviral; Pegylated form; Pyrimidine nucleoside; DNA polymerase inhibitor; Viral hepatitis C; Emtricitabine; Human; Immunopathology; Drug combination; Acyclic nucleotide; Treatment efficiency; Cytokine; Lamivudine; AIDS; Organic phosphonate; Immune deficiency; Infection; Chemotherapy; Treatment; Dideoxynucleoside; Viral disease; Abacavir; Digestive diseases; Interferon
• ISSN: 0305-7453; 1460-2091; 1460-2091
• DOI: 10.1093/jac/dkn420

Objectives To compare the response to hepatitis C virus (HCV) therapy among human immunodeficiency virus (HIV)/HCV co-infected patients receiving a nucleos(t)ide reverse transcriptase inhibitor [N(t)RTI] backbone consisting of abacavir plus lamivudine with that observed in subjects who receive tenofovir plus lamivudine or emtricitabine. Methods A total of 256 subjects, enrolled in a cohort of 948 HIV-infected patients who received pegylated interferon and ribavirin from October 2001 to January 2006, were included in this study. All patients were taking one protease inhibitor or one non-nucleoside reverse transcriptase inhibitor and abacavir plus lamivudine or tenofovir plus lamivudine or emtricitabine as N(t)RTI backbone during HCV therapy. Sustained virological response (SVR) rates in both backbone groups were compared. Results In an intention-to-treat analysis, 20 out of 70 (29%) individuals under abacavir and 83 out of 186 (45%) under tenofovir showed SVR (P = 0.02). N(t)RTI backbone containing tenofovir was an independent predictor of SVR in the multivariate analysis [adjusted odds ratio (95% CI), 2.6 (1.05–6.9); P = 0.03]. The association between abacavir use and lower SVR was chiefly seen in patients with plasma HCV-RNA load higher than 600 000 IU/mL and genotype 1 or 4. Among patients treated with ribavirin dose <13.2 mg/kg/day, 3 (20%) of those under abacavir versus 22 (52%) under tenofovir reached SVR (P = 0.03), whereas the rates were 31% and 38% (P = 0.4), respectively, in those receiving ≥13.2 mg/kg/day. Conclusions HIV-infected patients who receive abacavir plus lamivudine respond worse to pegylated interferon plus ribavirin than those who are given tenofovir plus lamivudine or emtricitabine as N(t)RTI backbone, especially in those receiving lower ribavirin doses.