Sustained Virological Response to Interferon Plus Ribavirin Reduces Non—Liver-Related Mortality in Patients Coinfected With HIV and Hepatitis C Virus

• Published in: Clinical infectious diseases Vol. 55; no. 5; pp. 728 - 736
• Main Authors: Berenguer, Juan, Rodríguez, Elena, Miralles, Pilar, Von Wichmann, Miguel A., López-Aldeguer, José, Mallolas, Josep, Galindo, María J., Van Den Eynde, Eva, Téllez, María J., Quereda, Carmen, Jou, Antoni, Sanz, José, Barros, Carlos, Santos, Ignacio, Pulido, Federico, Guardiola, Josep M., Ortega, Enrique, Rubio, Rafael, Jusdado, Juan J., Montes, María L., Gaspar, Gabriel, Esteban, Herminia, Bellón, José M., González-García, Juan
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2012
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Carts; Cohort Studies; Coinfection - drug therapy; Coinfection - epidemiology; Coinfection - virology; Female; Fibrosis; Hepatitis; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C - virology; Hepatitis C virus; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - virology; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Interferons; Interferons - therapeutic use; Kaplan-Meier Estimate; Liver; Liver diseases; Male; Medical sciences; Mortality; Pharmacology. Drug treatments; Proportional Hazards Models; Regression analysis; Ribavirin - therapeutic use; Spain - epidemiology; T lymphocytes; Transponders; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Viral Load; Virology; Spain; Mixed infection; Prognosis; Liver; Hepatic disease; Ribavirin; Nucleoside analog; Antiviral; Viral hepatitis C; Human; Immunopathology; Drug combination; Mortality; Cytokine; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Viral disease; Digestive diseases; Interferon; Human immunodeficiency virus; Flaviviridae; Hepatitis C virus; Hepacivirus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/cid/cis500

Background. Sustained virological response (SVR) after therapy with interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). We assessed the effect of SVR on HIV progression and mortality not related to liver disease. Methods. An observational cohort study including consecutive HIV/HCV-coinfected patients treated with interferon plus ribavirin between 2000 and 2008 in 19 centers in Spain. Results. Of 1599 patients, 626 (39%) had an SVR. After a median follow-up of approximately 5 years, we confirmed that failure to achieve an SVR was associated with an increased risk of liver-related events and liver-related death. We also observed higher rates of the following events in nonresponders than in responders: AIDS-defining conditions (rate per 100 person years, 0.84 [95% confidence interval (CI), .59–1.10] vs 0.29 [.10–.48]; P = .003), non—liver-related deaths (0.65 [.42–.87] vs 0.16 [.02–.30]; P = .002), and non—liver-related, non—AIDS-related deaths (0.55 [.34–.75] vs 0.16 [.02–.30]; P = .002). Cox regression analysis showed that the adjusted hazard ratios of new AIDS-defining conditions, non—liver-related deaths, and non—liver-related, non—AIDS-related deaths for nonresponders compared with responders were 1.90 (95% CI, .89–4.10; P = .095), 3.19 (1.21–8.40; P = .019), and 2.85 (1.07–7.60; P = .036), respectively. Conclusions. Our findings suggest that eradication of HCV after therapy with interferon plus ribavirin in HIV/HCV-coinfected patients is associated not only with a reduction in liver-related events but also with a reduction in HIV progression and mortality not related to liver disease.