title: Response to pegylated interferon plus ribavirin among HIV/hepatitis C virus-coinfected patients with compensated liver cirrhosis.
abstract: BACKGROUND
  The objective of this study was to determine the efficacy of pegylated interferon (peg-IFN) plus ribavirin (RBV) in human immunodeficiency virus (HIV)-infected patients with hepatitis C virus (HCV)-related compensated liver cirrhosis, as well as the predictors of response in these individuals.
  
  
  METHODS
  All subjects enrolled in a prospective cohort of 841 HIV/HCV-coinfected patients who received peg-IFN and RBV and who had a liver biopsy or a liver stiffness measurement within the year before starting peg-IFN plus RBV were included in this study. The sustained virologic response (SVR) rate and predictors of SVR response were analyzed.
  
  
  RESULTS
  A total of 629 patients were included in this study; 175 (28%) had cirrhosis. In an intention-to-treat analysis, 44 (25%) patients with cirrhosis and 177 (39%) without cirrhosis achieved SVR (P = .001). Among patients with cirrhosis, SVR was observed in 14%, 47%, and 30% of individuals with HCV genotypes 1, 2-3, and 4, respectively. Discontinuation of therapy owing to adverse events was observed in 30 (17%) individuals with cirrhosis and 37 (8%) subjects without cirrhosis (P = .001).
  
  
  CONCLUSIONS
  The efficacy of peg-IFN plus RBV among HIV/HCV-coinfected patients with cirrhosis is lower than in those without cirrhosis, although this antiviral combination still leads to a substantial rate of SVR in those carrying HCV genotype 3. A higher rate of discontinuations of HCV therapy due to adverse events among cirrhotic patients could partially explain the differences in the SVR rate between both populations.
authors.affiliation: Unidad de Enfermedades Infecciosas y Microbiología Clínica, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Mira
authors.forename: Silvia
authors.initials: S
authors.lastname: García-Rey
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
authors.forename: Ignacio
authors.initials: I
authors.lastname: de los Santos-Gil
authors.forename: Luis F
authors.initials: LF
authors.lastname: López-Cortés
authors.forename: José A
authors.initials: JA
authors.lastname: Girón-González
authors.forename: Francisco
authors.initials: F
authors.lastname: Téllez
authors.forename: Manuel
authors.initials: M
authors.lastname: Márquez
authors.forename: Dolores
authors.initials: D
authors.lastname: Merino
authors.forename: María J
authors.initials: MJ
authors.lastname: Ríos-Villegas
authors.forename: Juan
authors.initials: J
authors.lastname: Macías
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero-Juárez
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D019562:Viral Load / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b