Degree of viral decline early in treatment predicts sustained virological response in HCV-HIV coinfected patients treated with peginterferon alfa-2a and ribavirin.
BACKGROUND
In hepatitis C virus (HCV) monoinfection, the on-treatment virological response at Weeks 4 and 12 is a strong predictor of treatment outcomes.


METHODS
In a retrospective analysis, we examined these responses in 289 HIV-HCV coinfected patients treated with Peg-IFN alfa-2a /ribavirin for 48 weeks in a large randomized, multinational trial (APRICOT).


RESULTS
Overall, 21% of patients achieved a rapid virological response at Week 4 and, of these, 88% achieved a sustained virological response. An early virological response at Week 12 was achieved in 71% of patients, and 56% of these patients achieved a sustained virological response. These results are similar to the sustained virological response rates obtained in monoinfected patients who achieve a rapid or early virological response. Patients who did not achieve a rapid virological response but who had unquantifiable HCV RNA or > 3 log10 drop over baseline also had high sustained virological response rates. A total of 46% of patients achieved undetectable HCV RNA (<50 IU/mL) at Week 12. Multiple logistic regression analysis showed that infection with HCV genotype 2/3, low baseline HCV RNA level, and lower age predicted rapid virological response. Infection with HCV genotype 2/3 and low baseline HCV RNA level predicted early virological response.


CONCLUSIONS
A rapid virological response is the best predictor of a sustained virological response, and lack of an early virological response is the best predictor of no sustained virological response. Such results are consistent with findings in HCV monoinfected patients.
Rodriguez-Torres
M
M
Fundación de Investigación de Diego, Santurce, Puerto Rico. rodztorres@coqui.net
Torriani
F
F
Rockstroh
J
J
Depamphilis
J
J
Carosi
G
G
Dieterich
D T
DT
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006678:HIV / Q000254:growth & development*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D016174:Hepacivirus / Q000254:growth & development*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a