title: Pegylated interferon plus ribavirin in HIV-infected patients with recurrent hepatitis C after liver transplantation: a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the results of treatment with pegylated interferon and ribavirin for the recurrence of hepatitis C after liver transplantation in HCV/HIV-coinfected patients.
  
  
  METHODS
  This was a prospective, multicentre cohort study, including 78 HCV/HIV-coinfected liver transplant patients who received treatment for recurrent hepatitis C. For comparison, we included 176 matched HCV-monoinfected patients who underwent liver transplantation during the same period of time at the same centres and were treated for recurrent hepatitis C.
  
  
  RESULTS
  Antiviral therapy was discontinued prematurely in 56% and 39% (p = 0.016), mainly because of toxicity (22% and 11%, respectively; p=0.034). Sustained virological response (SVR) was achieved in 21% of the coinfected patients and in 36% of monoinfected patients (p = 0.013). For genotype 1, SVR rates were 10% and 33% (p = 0.002), respectively; no significant differences were observed for the other genotypes. A multivariate analysis based on the whole series identified HIV-coinfection as an independent predictor of lack of SVR (OR, 0.17; 95% CI, 0.06-0.42). Other predictors of SVR were donor age, pretreatment HCV viral load, HCV genotype, and early virological response. SVR was associated with a significant improvement in survival: 5-year survival after antiviral treatment was 79% for HCV/HIV-coinfected patients with SVR vs. 43% for those without (p = 0.02) and 92% vs. 60% in HCV-monoinfected patients (p < 0.001), respectively.
  
  
  CONCLUSIONS
  The response to pegylated interferon and ribavirin was poorer in HCV/HIV-coinfected liver recipients, particularly those with genotype 1. However, when SVR was achieved, survival of coinfected patients increased significantly.
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autónoma de Barcelona, Barcelona, Spain; CIBEREHD, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Castells
authors.affiliation: CIBEREHD, Barcelona, Spain; Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rimola
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Hospital de Cruces, University of the Basque Country, Bilbao, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Valdivieso
authors.affiliation: Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Montero
authors.affiliation: Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Barcena
authors.affiliation: Hospital Universitario Doce de Octubre, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Abradelo
authors.affiliation: Hospital de Bellvitge-IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Xiol
authors.affiliation: Hospital Universitari La Fe, Valencia, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Aguilera
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Salcedo
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Bernal
authors.affiliation: Complejo Hospitalario Universitario, A Coruña, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Suarez
authors.affiliation: Hospital Universitario de Santiago de Compostela, La Coruña, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Antela
authors.affiliation: Hospital Universitario Doce de Octubre, Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Olivares
authors.affiliation: Hospital Universitario Ramón y Cajal-IRYCIS, Madrid, Spain.
authors.forename: Santos
authors.initials: S
authors.lastname: Del Campo
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Laguno
authors.affiliation: Hospital de Cruces, University of the Basque Country, Bilbao, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Fernandez
authors.affiliation: Organización Nacional de Trasplantes, Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: de la Rosa
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Agüero
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Perez
authors.affiliation: Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autónoma de Barcelona, Barcelona, Spain; CIBEREHD, Barcelona, Spain.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Esteban-Mur
authors.affiliation: Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miro
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D060085:Coinfection; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D011994:Recombinant Proteins / Q000008:administration & dosage; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004337:Drug Carriers; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
keywords: Antiviral treatment; HCV infection; HIV infection; Liver transplantation; Pegylated-interferon; Recurrence of hepatitis C; Ribavirin; Survival