title: Benefits from sustained virologic response to pegylated interferon plus ribavirin in HIV/hepatitis C virus-coinfected patients with compensated cirrhosis.
abstract: BACKGROUND
  The objective of this study was to determine the impact of sustained virologic response (SVR) to pegylated interferon (peg-IFN) plus ribavirin (RBV) on the incidence of liver-related complications and overall mortality in human immunodeficiency virus (HIV)-infected patients with compensated hepatitis C virus (HCV)-related cirrhosis.
  
  
  METHODS
  We included in this prospective cohort study 166 coinfected patients with compensated cirrhosis, who received peg-IFN plus RBV, to assess the time from the starting date of HCV therapy to the first hepatic decompensation and death due to any cause.
  
  
  RESULTS
  SVR was observed in 43 (25%) individuals. Two (4.6%) patients with SVR developed liver decompensation vs 33 (26.8%) individuals without SVR (P = .002). The incidence of liver-related complications was 0.89 cases per 100 person-years (95% confidence interval [CI], .11-3.1) in SVR patients and 6.4 cases per 100 person-years (95% CI, 4.5-8.9) in non-SVR patients. Factors independently associated with liver decompensation were non-SVR (hazard ratio [HR], 8.1; 95% CI, 1.08-61.5; P = .042) and MELD score ≥9 at baseline (HR, 2.9; 95% CI, 1.2-7.2; P = .016). Two (4.6%) patients with SVR died due to any cause compared with 22 (17.9%) individuals without SVR (P = .02). MELD score ≥9 (HR, 3.1; 95% CI, 1.3-7.7; P = .011) and non-SVR (HR, 8.0; 95% CI, 1.07-61; P = .043) were independently associated with overall mortality.
  
  
  CONCLUSIONS
  The achievement of SVR following peg-IFN plus RBV markedly reduces the incidence of liver-related decompensation and the overall mortality in HIV/HCV-coinfected patients with compensated cirrhosis.
authors: Unidad de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario de Valme, Avenida de Bellavista s/n, 41014 Sevilla, Spain.
authors: José A
authors: JA
authors: Mira
authors: Antonio
authors: A
authors: Rivero-Juárez
authors: Luis F
authors: LF
authors: López-Cortés
authors: José A
authors: JA
authors: Girón-González
authors: Francisco
authors: F
authors: Téllez
authors: Ignacio
authors: I
authors: de los Santos-Gil
authors: Juan
authors: J
authors: Macías
authors: Dolores
authors: D
authors: Merino
authors: Manuel
authors: M
authors: Márquez
authors: María J
authors: MJ
authors: Ríos-Villegas
authors: Isabel
authors: I
authors: Gea
authors: Nicolás
authors: N
authors: Merchante
authors: Antonio
authors: A
authors: Rivero
authors: Almudena
authors: A
authors: Torres-Cornejo
authors: Juan A
authors: JA
authors: Pineda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000821:virology*; D016174:Hepacivirus / Q000187:drug effects; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000821:virology*; D017093:Liver Failure / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
keywords: HCV; HIV; cirrhosis; liver decompensation; sustained virologic response