title: Re-treatment of chronic HCV infection in HIV co-infected patients and predictors of sustained viral response.
abstract: BACKGROUND
  In HIV-HCV co-infected patients who failed to achieve sustained viral response (SVR) with PEG-IFN + RBV, data on SVR rate after re-treatment with Peginterferon (PEG-IFN) + ribavirin (RBV) are scarce.
  
  
  OBJECTIVE
  The aim of this study was to identify factors predictive of SVR after re-treatment in a large cohort of HIV/HCV co-infected patients - the ANRS-CO7 Ribavic cohort study, which is a long term follow-up study of patients who were included in the randomized controlled trial ANRS-HC02 RIBAVIC.
  
  
  RESULTS
  Among the 176 patients who did not achieve a SVR during the RIBAVIC trial, sixty-six patients (38%) experienced a re-treatment with PEG-IFN + RBV. The SVR observed to the second course of HCV treatment was 44% overall, i.e. 93% in patients who were relapsers and 29% in nonresponders. In the nonresponders subgroup, the SVR rate was 42% in patients with genotype 2-3 and 26% in patients with genotype 1-4. In multivariate analysis, age ≤ 40 years (OR 12.4 95% CI 1.9-171, p = 0.003), genotype 2-3 versus 1-4 (OR 8.1 95% CI 8.1 1.2-97, p = 0.002) and relapser status at first treatment (OR 32.9 95% CI 3.2-278, p < 0.0001) were significantly associated with SVR.
  
  
  CONCLUSIONS
  Our findings strongly suggest that patients who relapse after first treatment, particularly those infected with HCV genotype 2-3, or living in countries with no access to the direct acting antiviral drugs for HCV, could be successfully re-treated with standard bi-therapy of PEG-IFN + RBV regimen.
authors.affiliation: U707, INSERM, Paris - UMR-sS707, UPMC, Paris, France; Service de Maladies Infectieuses et Tropicales, APHP, Le Kremlin Bicetre, France; Groupe Hospitalier Universitaire Paris-Sud, AP-HP, INSERM U1018, Le Kremlin Bicêtre, France. Electronic address: krastinova@gmail.com.
authors.forename: Evguenia
authors.initials: E
authors.lastname: Krastinova
authors.affiliation: U707, INSERM, Paris - UMR-sS707, UPMC, Paris, France; Unité des Maladies Infectieuses et Tropicales, Hôpital Robert Debré, Faculté de Médecine de Reims, Reims, France. Electronic address: fbanisadr@chu-reims.fr.
authors.forename: Firouzé
authors.initials: F
authors.lastname: Bani-Sadr
authors.affiliation: U707, INSERM, Paris - UMR-sS707, UPMC, Paris, France. Electronic address: delphine.fromentin@gmail.com.
authors.forename: Delphine
authors.initials: D
authors.lastname: Fromentin
authors.affiliation: Groupe Hospitalier Universitaire Paris-Sud, AP-HP, INSERM U1018, Le Kremlin Bicêtre, France. Electronic address: cecile.goujard@bct.aphp.fr.
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.affiliation: CHU de Bordeaux, Services de Médecine Interne et Maladies Infectieuses, Bordeaux, France. Electronic address: mojgan.hessamfar@chu-bordeaux.fr.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Hessamfar
authors.affiliation: Service Universitaire des Maladies Infectieuses et du Voyageur, Hôpital Bichat, APHP, Equipe ATIP/Avenir Aide à la décision, Modélisation, et coût-efficacité en Maladies Infectieuses, INSERM U738, Université Paris Diderot, France. Electronic address: yyazdan@yahoo.com.
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.affiliation: Université Paris Descartes, APHP, Unité d'Hépatologie Paris et INSERM U-1016, Institut Cochin, Hôpital Cochin, Paris, France. Electronic address: stanislas.pol@cch.aphp.fr.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Service de médecine interne, APHP, Paris, UMR 7087, Université Pierre et Marie Curie (UPMC-Paris 6), Paris, France. Electronic address: patrice.cacoub@psl.aphp.fr.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.affiliation: Centre Hospitalier Universitaire Raymond Poincaré, Université de Versailles, Garches, France. Electronic address: c.perronne@rpc.aphp.fr.
authors.forename: Christian
authors.initials: C
authors.lastname: Perronne
authors.affiliation: U707, INSERM, Paris - UMR-sS707, UPMC, Paris, France; Unité de santé publique, APHP, Paris, France. Electronic address: carrat@u707.jussieu.fr.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons
keywords: HCV re-treatment; HCV relapsers; HCV sustained viral response; HIV/HCV coinfection; Peginterferon alfa plus ribavirin