title: Role of viral kinetics under HCV therapy in HIV/HCV-coinfected patients.
abstract: Patients coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are less responsive to anti-HCV therapies and are at a higher risk of toxicity than HCV monoinfected patients. HCV viral kinetics is the basis for the study of response to interferon-based therapy and for predicting sustained virological response (SVR). A lack of early virological response (EVR; undetectable HCV RNA or a decrease of >/=2 log(10) from baseline) after 12 weeks of pegylated interferon (peg-IFN) plus ribavirin (RBV) is an equally reliable predictor of lack of SVR in HIV/HCV-coinfected patients and in the monoinfected HCV population. Early stopping rules are particularly important in coinfected HIV/HCV patients, considering their low chances of response in the more difficult-to-treat HCV genotypes 1 and 4 (<30%). Several factors have been involved in this low efficacy, including higher baseline HCV viraemia, slower viral kinetics decay under interferon pressure and a defective immune substratum. A better understanding of HCV viral kinetics under HCV therapy may be the basis for assaying different peg-IFN plus RBV schedules, such as induction or extending strategies, and may help physicians to make tailored decisions for the management of their patients.
authors.affiliation: HIV Clinical Unit, Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Barcelona, Spain.
authors.forename: Angel Luis
authors.initials: AL
authors.lastname: Ballesteros
authors.forename: Daniel
authors.initials: D
authors.lastname: Fuster
authors.forename: Ramon
authors.initials: R
authors.lastname: Planas
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
authors.forename: Cristina
authors.initials: C
authors.lastname: Tural
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications / Q000821:virology*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral