JAC Advance Access originally published online on October 14, 2007
Journal of Antimicrobial Chemotherapy 2007 60(6):1347-1354; doi:10.1093/jac/dkm373
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Influence of concomitant antiretroviral therapy on the rate of sustained virological response to pegylated interferon plus ribavirin in hepatitis C virus/HIV-coinfected patients












1 Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, Spain 2 Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, Spain 3 Servicio de Medicina Interna-Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain 4 Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, Spain 5 Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain 6 Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, Spain 7 Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Puerta del Mar, Cádiz, Spain 8 Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain 9 Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain 10 Servicio de Medicina Interna, Hospital Torrecárdenas, Almería, Spain
Received 9 May 2007; returned 27 June 2007; revised 2 September 2007; accepted 4 September 2007
* Corresponding author. Tel: +34-955015864; Fax: +34-955015787; E-mail: japineda{at}telefonica.net
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.
Keywords: tenofovir , stavudine , abacavir
For the Grupo para el Estudio de las Hepatitis Víricas de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI).
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