Baseline CD4 cell count and outcome of pegylated interferon plus ribavirin therapy in HIV/hepatitis C virus-coinfected patients.
OBJECTIVE
When to start hepatitis C treatment in HIV/hepatitis C virus (HCV)-coinfected patients remains unresolved. Our objective was to determine if a baseline CD4 count >/=350 cells/mm predicts a sustained HCV response to pegylated interferon plus ribavirin.


METHODS
We conducted a multicenter cohort study of HIV/HCV-coinfected patients treated for HIV in hospitals in Nice, Tourcoing, and Marseille (France). Sustained viral response (SVR) was defined as undetectable HCV RNA 24 weeks after treatment. The relation between CD4 cell count and SVR was examined separately for patients with HCV genotype 1 or non-1.


RESULTS
One hundred seventy-five patients were included. In patients with HCV genotype 1, the rate of SVR was 13% and was not related to baseline CD4 cell count (odds ratio [OR] = 1.0, 95% confidence interval [CI]: 0.1 to 9.3). In patients with HCV genotype non-1, the rate of SVR was 46% and was not significantly increased by a baseline CD4 count >/=350 cells/mm (OR = 1.8, 95% CI: 0.6 to 5.9).


CONCLUSIONS
Higher CD4 cell count at treatment initiation with pegylated interferon plus ribavirin did not improve treatment success probability, regardless of HCV genotype.
D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a