title: Sustained virological response to interferon plus ribavirin reduces non-liver-related mortality in patients coinfected with HIV and Hepatitis C virus.
abstract: BACKGROUND
  Sustained virological response (SVR) after therapy with interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). We assessed the effect of SVR on HIV progression and mortality not related to liver disease.
  
  
  METHODS
  An observational cohort study including consecutive HIV/HCV-coinfected patients treated with interferon plus ribavirin between 2000 and 2008 in 19 centers in Spain.
  
  
  RESULTS
  Of 1599 patients, 626 (39%) had an SVR. After a median follow-up of approximately 5 years, we confirmed that failure to achieve an SVR was associated with an increased risk of liver-related events and liver-related death. We also observed higher rates of the following events in nonresponders than in responders: AIDS-defining conditions (rate per 100 person years, 0.84 [95% confidence interval (CI), .59-1.10] vs 0.29 [.10-.48]; P= .003), non-liver-related deaths (0.65 [.42-.87] vs 0.16 [.02-.30]; P = .002), and non-liver-related, non-AIDS-related deaths (0.55 [.34-.75] vs 0.16 [.02-.30]; P = .002). Cox regression analysis showed that the adjusted hazard ratios of new AIDS-defining conditions, non-liver-related deaths, and non-liver-related, non-AIDS-related deaths for nonresponders compared with responders were 1.90 (95% CI, .89-4.10; P = .095), 3.19 (1.21-8.40; P = .019), and 2.85 (1.07-7.60; P = .036), respectively.
  
  
  CONCLUSIONS
  Our findings suggest that eradication of HCV after therapy with interferon plus ribavirin in HIV/HCV-coinfected patients is associated not only with a reduction in liver-related events but also with a reduction in HIV progression and mortality not related to liver disease.
authors.affiliation: Infectious Diseases and HIV Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Doctor Esquerdo 46, 28007 Madrid, Spain. juangonzalezgar@gmail.com
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Elena
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Von Wichmann
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.forename: Josep
authors.initials: J
authors.lastname: Mallolas
authors.forename: María J
authors.initials: MJ
authors.lastname: Galindo
authors.forename: Eva
authors.initials: E
authors.lastname: Van Den Eynde
authors.forename: María J
authors.initials: MJ
authors.lastname: Téllez
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: Antoni
authors.initials: A
authors.lastname: Jou
authors.forename: José
authors.initials: J
authors.lastname: Sanz
authors.forename: Carlos
authors.initials: C
authors.lastname: Barros
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.forename: Josep M
authors.initials: JM
authors.lastname: Guardiola
authors.forename: Enrique
authors.initials: E
authors.lastname: Ortega
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Jusdado
authors.forename: María L
authors.initials: ML
authors.lastname: Montes
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gaspar
authors.forename: Herminia
authors.initials: H
authors.lastname: Esteban
authors.forename: José M
authors.initials: JM
authors.lastname: Bellón
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D060085:Coinfection / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012254:Ribavirin / Q000627:therapeutic use*; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons