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JAC Advance Access first published online on October 14, 2007
This version published online on November 7, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm373
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© The Author 2007. 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

Influence of concomitant antiretroviral therapy on the rate of sustained virological response to pegylated interferon plus ribavirin in hepatitis C virus/HIV-coinfected patients

Juan A. Pineda1,*,{dagger}, José A. Mira2,{dagger}, Ignacio de los Santos Gil3, Bárbara Valera-Bestard4,{dagger}, Antonio Rivero5,{dagger}, Dolores Merino6,{dagger}, José A. Girón-González7,{dagger}, María J. Ríos-Villegas8,{dagger}, Mercedes González-Serrano9,{dagger}, Antonio Collado10,{dagger}, José A. García-García2,{dagger}, Raquel Carrillo-Gómez3, Luis F. López-Cortés4,{dagger} and Jesús Gómez-Mateos1,{dagger}

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.

Key Words: tenofovir , stavudine , abacavir

{dagger} For the Grupo para el Estudio de las Hepatitis Víricas de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI).


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J. A. Mira, L. F. Lopez-Cortes, P. Barreiro, C. Tural, M. Torres-Tortosa, I. de los Santos Gil, P. Martin-Rico, M. J. Rios-Villegas, J. J. Hernandez-Burruezo, D. Merino, et al.
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J. Antimicrob. Chemother., December 1, 2008; 62(6): 1365 - 1373.
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