Impact of hyperglycaemia and cholesterol levels on the outcome of hepatitis C virus (HCV) treatment in HIV/HCV-coinfected patients.
OBJECTIVE
High serum total cholesterol and low-density lipoprotein (LDL) levels have been demonstrated to increase the probability of a sustained viral response (SVR) in chronic hepatitis C. Conversely, insulin resistance reduces SVR rates. We investigated the influence of baseline glucose and lipid values on the outcome of hepatitis C virus (HCV) treatment in HIV-1 infected subjects.


METHODS
We retrospectively reviewed the charts of HIV/HCV-coinfected patients treated with an interferon-based regimen from 2002 to 2008. Fasting glucose levels and total cholesterol, LDL and triglyceride levels were recorded prior to the initiation of treatment.


RESULTS
Of the 96 patients enrolled in the study, 36 (37.5%) had genotype 1, 48 (50%) genotype 2 or 3 and 12 (12.5%) genotype 4. SVR was obtained in 25% (nine of 36) and 70% (42 of 60) of patients with genotype 1 and other genotypes, respectively. In the multivariate analysis, the independent predictors of SVR were: genotype other than genotype 1 [adjusted odds ratio 9.64, confidence interval (CI) 2.7-34.3; P<0.0001], HCV viraemia [adjusted odds ratio 0.36, CI 0.15-0.9; P=0.028], fasting glucose > or =100 mg/dL [adjusted odds ratio 0.13, CI 0.034-0.51; P=0.003], and cholesterol level > or =190 mg/dL [adjusted odds ratio 5.96, CI 1.6-22.3; P=0.008].


CONCLUSIONS
Higher baseline serum glucose and cholesterol levels may be significant prognostic indicators for anti-HCV treatment outcome in HIV/HCV-coinfected patients.
Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy.
M
M
Cesari
I
I
Caramma
S
S
Antinori
F
F
Adorni
M
M
Galli
L
L
Milazzo
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood*; D006943:Hyperglycemia / Q000097:blood*; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008060:Lipodystrophy / Q000209:etiology; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
D000998:Antiviral Agents; D001786:Blood Glucose; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D008077:Lipoproteins, LDL; D011994:Recombinant Proteins; D014280:Triglycerides; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b