Correlates of HIV sustained viral suppression in HIV/hepatitis C virus coinfected patients: possible role of the hepatitis C virus sustained viral response.
BACKGROUND
The impact of hepatitis C virus (HCV)-related characteristics such as genotype, viral load or liver fibrosis on the chances of achieving sustained HIV suppression in coinfected patients is not fully documented.


METHODS
We examined the relationship between both HIV/HCV-related and sociobehavioural characteristics and HIV sustained viral suppression (SVS) in 897 patients included in the ANRS CO13 HEPAVIH cohort.


RESULTS
The main outcome variable was HIV SVS, defined as at least two consecutive undetectable HIV viral loads. Among the 897 HIV/HCV-coinfected patients, 419 (47%) had received HCV therapy at least once, and 103 patients (25%) had experienced an HCV sustained virologic response (SVR). In multivariate analysis, older age [odds ratio (OR) 1.23 for each period of 5 years of age, 95% confidence interval (CI) 1.02-1.49; P = 0.03], a higher level of school education (OR 1.92, 95% CI 1.04-3.56; P = 0.04), good adherence to HIV therapy (OR 2.05, 95% CI 1.23-3.43; P = 0.006) and HCV SVR (OR 1.81, 95% CI 1.01-3.26; P = 0.04) remained significantly associated with HIV SVS. In contrast, triple nucleoside reverse transcriptase inhibitor (NRTI) regimens were associated with failure to achieve HIV SVS (OR 0.50, 95% CI 0.27-0.94; P = 0.03). Our results show that HCV SVR is associated with a higher likelihood of achieving HIV SVS.


CONCLUSIONS
With the advent of direct-acting anti-HCV drugs, a marked increase in the rate of virologic response is observed in coinfected patients. So, further research is needed to determine whether suppression of HCV replication could be associated with a higher efficacy of antiretroviral therapy.
aUnité des Maladies Infectieuses et Tropicales, Hôpital Robert Debré, Université Champagne Ardenne, Reims bINSERM, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistiques, Bordeaux cINSERM, U912 (SE4S)- Université Aix Marseille, IRD, UMR-S912- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille dService des Maladies Infectieuses et Tropicales, Groupe Hospitalier Necker-Enfants Malades, AP-HP, Paris eService des Maladies Infectieuses et Tropicales, Groupe Hospitalier Avicenne, AP-HP, Bobigny fService des Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard gService des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP- Université Paris Descartes, Paris, France.
Firouzé
F
Bani-Sadr
Marc-Arthur
MA
Loko
Elodie
E
Pambrun
Maria
M
Winnock
Patrizia
P
Carrieri
Camille
C
Gilbert
Claudine
C
Duvivier
Olivier
O
Bouchaud
Anne
A
Gervais
Francois
F
Dabis
Dominique
D
Salmon
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
D044966:Anti-Retroviral Agents; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors