title: Poor response to hepatitis C virus (HCV) therapy in HIV- and HCV-coinfected patients is not due to lower adherence to treatment.
abstract: The degree of adherence to anti-hepatitis C virus (HCV) therapy among HIV/HCV-coinfected patients is not known. A prospective cohort study was performed in two groups of patients: 79 HIV/HCV-coinfected patients (group 1) and 78-HCV-monoinfected patients (group 2). Patients were treated with interferon alpha-2a (3 million international units [MIU], three times per week) plus ribavirin (1000-1200 mg/day) for 48 weeks. Adherence to therapy was defined as having received +/-80% of both drug dosages for +/-80% of the expected duration of therapy. The degree of adherence to treatment was similar for patients with or without HIV coinfection (72.2 versus 80.8%). The overall sustained virological response (SVR) in patients with adherence to therapy was 41.7% as compared with only 8.1% (p = 0.0001) in patients without adherence. The difference in SVR rate according to adherence to treatment was also evident in patients of group 1 (29.8% versus 9.1%; p = 0.05) as well as in those of group 2 (52.4 versus 6.7%; p = 0.001). Adherence to anti-HCV therapy, which can be similar in mono- and coinfected patients, enhances the likelihood of achieving an increase in SVR rate. In addition to improved adherence, in coinfected patients more aggressive therapeutic strategies may be necessary to achieve SVR.
authors.affiliation: Liver Section, Hospital del Mar, Institut Municipal d'Investigació Médica, Universitat Autònoma de Barcelona, 08003 Barcelona, Spain. 35783m@imas.imim.es
authors.forename: Ricard
authors.initials: R
authors.lastname: Solà
authors.forename: Josep Antón
authors.initials: JA
authors.lastname: Galeras
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoliu
authors.forename: Cristina
authors.initials: C
authors.lastname: Tural
authors.forename: Lluis
authors.initials: L
authors.lastname: Force
authors.forename: Sandra
authors.initials: S
authors.lastname: Torra
authors.forename: Santiago
authors.initials: S
authors.lastname: Montull
authors.forename: Eduardo Rodríguez De
authors.initials: ER
authors.lastname: Castro
authors.forename: Susanna
authors.initials: S
authors.lastname: Coll
authors.forename: Daniel
authors.initials: D
authors.lastname: Fuster
authors.forename: Pilar
authors.initials: P
authors.lastname: Barrufet
authors.forename: Guillem
authors.initials: G
authors.lastname: Sirera
authors.forename: Maria Dolors
authors.initials: MD
authors.lastname: Giménez
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
authors.forename: Ramón
authors.initials: R
authors.lastname: Planas
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin