Association of baseline CD4+ cell count and HIV-RNA on sustained virologic response to interferon-ribavirin in HIV/HCV coinfected patients

• Published in: Annals of hepatology Vol. 14; no. 4; pp. 464 - 469
• Main Authors: Aldámiz-Echevarría, Teresa, González-García, Juan, Von Wichmann, Miguel A, Crespo, Manel, López-Aldeguer, José, Quereda, Carmen, Téllez, María J, Galindo, María J, Sanz, José, Santos, Ignacio, Guardiola, Josep M, Bellón, José M, Montes, Marisa, Berenguer, Juan, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01.07.2015
• Subjects: Adult; Anti-HIV Agents - therapeutic use; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; CD4 Lymphocyte Count; Chronic hepatitis C; Coinfection; Female; Gastroenterology and Hepatology; Genotype; Hepacivirus - drug effects; Hepacivirus - genetics; Hepatitis C; Hepatitis C - blood; Hepatitis C - diagnosis; Hepatitis C - drug therapy; HIV - drug effects; HIV - genetics; HIV Infections - blood; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; Human immunodeficiency virus; Humans; Interferons - adverse effects; Interferons - therapeutic use; Logistic Models; Male; Multivariate Analysis; Odds Ratio; Pegylated interferon; Predictive Value of Tests; Retrospective Studies; Ribavirin - adverse effects; Ribavirin - therapeutic use; Risk Factors; RNA, Viral - blood; RNA, Viral - genetics; Spain; Sustained viral response; Time Factors; Treatment Outcome; Viral Load; Spain; Chronic hepatitis C; Human immunodeficiency virus; Hepatitis C; Pegylated interferon; Sustained viral response
• DOI: 10.1016/S1665-2681(19)31167-6
• ISSN: 1665-2681

AbstractBackground and rationale for the study. We assessed the association of CD4+ T-cell counts and HIV-RNA on sustained viral response (SVR) after therapy with pegylated interferon and ribavirin (PR) in HIV/HCV coinfected patients. We examined two large cohorts of coinfected patients treated with PR in Spain between 2000 and 2008. SVR was defined as undetectable HCV-RNA at 24 weeks after the end of PR. Results. We studied 1682 patients, of whom 38% achieved SVR. Baseline factors independently associated with reduced odds of SVR included genotype 1 or 4, HCV-RNA > 500,000 IU/mL, advanced liver fibrosis, CDC clinical category C, and detectable HIV-RNA. By multivariate logistic regression analysis, we found that, in comparison with patients with combination antiretroviral therapy (cART) and undetectable HIV-RNA, the odds ratio [95% confidence interval (CI)] of SVR was 0.56 (0.41-0.78) for cART and detectable HIV-RNA, 0.86 (0.56-2.57) for no-cART and detectable HIV-RNA, and 1.38 (0.74-2.57) for no-cART and undetectable HIV-RNA. Conclusions. Detectable HIV-RNA, but not CD4+ T-cell count, was associated with reduced odds of SVR. However, this finding was only confirmed for cART and detectable HIV-RNA, raising the question as whether this represents a true association of HIV-RNA on response to PR or a spurious association due to poor adherence to treatment.