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JAC Advance Access originally published online on October 13, 2008
Journal of Antimicrobial Chemotherapy 2008 62(6):1365-1373; doi:10.1093/jac/dkn420
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

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

José A. Mira1,2,{dagger}, Luis F. López-Cortés3,{dagger}, Pablo Barreiro4, Cristina Tural5, Manuel Torres-Tortosa6,{dagger}, Ignacio de los Santos Gil7, Patricia Martín-Rico8,{dagger}, María J. Ríos-Villegas9,{dagger}, José Juan Hernández-Burruezo10,{dagger}, Dolores Merino11,{dagger}, Miguel Ángel López-Ruz12,{dagger}, Antonio Rivero13,{dagger}, Leopoldo Muñoz14,{dagger}, Mercedes González-Serrano15,{dagger}, Antonio Collado16,{dagger}, Juan Macías1,2,{dagger}, Pompeyo Viciana3,{dagger}, Vincent Soriano4 and Juan A. Pineda1,*,{dagger}

1 Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, Spain 2 Servicio de Medicina Interna, Hospital Universitario de Valme, Sevilla, Spain 3 Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, Spain 4 Servicio de Enfermedades Infecciosas, Hospital Carlos III, Madrid, Spain 5 Unidad Clínica de VIH, Servicio de Medicina Interna, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain 6 Sección de Enfermedades Infecciosas, Hospital Punta Europa, Algeciras, Spain 7 Servicio de Medicina Interna-Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain 8 Servicio de Enfermedades Infecciosas, Hospital Universitario Carlos Haya, Málaga, Spain 9 Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain 10 Unidad de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain 11 Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, Spain 12 Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, Granada, Spain 13 Sección de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain 14 Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario San Cecilio, Granada, Spain 15 Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain 16 Servicio de Medicina Interna, Hospital Torrecárdenas, Almería, Spain

Received 15 March 2008; returned 23 April 2008; revised 7 September 2008; accepted 14 September 2008

* Corresponding author. Tel: +34-955015864; Fax: +34-955015787; E-mail: japineda{at}telefonica.net

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.

Keywords: antiretroviral therapy , sustained virological response , HCV genotype

{dagger} Grupo HEPAVIR de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI)


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