title: Effects of sustained viral response in patients with HIV and chronic hepatitis C and nonadvanced liver fibrosis.
abstract: OBJECTIVE
  We assessed the effects of sustained viral response (SVR), after treating with interferon-ribavirin (IF-RB), on mortality, liver-related (LR) events (decompensation, hepatocellular carcinoma), HIV progression, and liver stiffness in HIV/hepatitis C virus (HCV)-coinfected patients with nonadvanced liver fibrosis.
  
  
  METHODS
  From a cohort of HIV/HCV-coinfected patients treated with IF-RB, we selected those with baseline liver fibrosis stages F0, F1, or F2 according to METAVIR. The study started when IF-RB was stopped and ended at death or at the last follow-up visit.
  
  
  RESULTS
  A total of 695 patients were included (HCV genotype 1 or 4, 431; F0, 77; F1, 290; and F2, 328), and 274 patients achieved SVR. After a median follow-up of 4.9 years, the adjusted hazard ratio (aHR) [95% confidence interval (CI)] of LR events or overall death, for patients with SVR taking the group of patients with no SVR as a reference was 0.217 (0.079 to 0.599) (P = 0.003) for the whole cohort with F0 to F2. For patients with F0, the aHR (95% CI) was 0.514 (0.040 to 6.593) (P = 0.609), for patients with F1, the aHR (95% CI) was 0.305 (0.053 to 1.762) (P = 0.185), and for patients with F2, it was 0.075 (0.009 to 0.662) (P = 0.020). We also found that, in comparison with no SVR, SVR was followed by less frequent HIV progression for the entire population (F0 to F2) and less frequent liver stiffness across all categories of fibrosis.
  
  
  CONCLUSIONS
  SVR in HIV/HCV-coinfected patients with moderate stages of liver fibrosis is associated with a reduction of mortality and LR events, and with a reduction of progression of HIV and liver fibrosis.
authors.affiliation: *Department of Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; †Department of Infectious Diseases, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; ‡Department of Infectious Diseases, Hospital Universitario La Paz, Madrid, Spain; §Department of Infectious Diseases, Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain; ‖Department of Infectious Diseases, Hospital Donostia, San Sebastián, Spain; ¶Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain; #Hospital Universitario La Fe, Valencia, Spain; **Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain; ††Department of Infectious Diseases, Hospital Clínico San Carlos, Madrid, Spain; ‡‡Department of Infectious Diseases, Hospital Clínico Universitario, Valencia, Spain; §§Department of Infectious Diseases, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain; ‖‖Department of Infectious Diseases, Hospital Universitario La Princesa, Madrid, Spain; ¶¶Department of Infectious Diseases, Hospital Santa Creu i Sant Pau, Barcelona, Spain; and ##Department of Infectious Diseases, Fundación SEIMC-GESIDA, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Francisco X
authors.initials: FX
authors.lastname: Zamora
authors.forename: Ana
authors.initials: A
authors.lastname: Carrero
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Von Wichmann
authors.forename: Manel
authors.initials: M
authors.lastname: Crespo
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.forename: Teresa
authors.initials: T
authors.lastname: Aldámiz-Echevarría
authors.forename: Marisa
authors.initials: M
authors.lastname: Montes
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: María J
authors.initials: MJ
authors.lastname: Téllez
authors.forename: María J
authors.initials: MJ
authors.lastname: Galindo
authors.forename: José
authors.initials: J
authors.lastname: Sanz
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.forename: Josep M
authors.initials: JM
authors.lastname: Guardiola
authors.forename: Herminia
authors.initials: H
authors.lastname: Esteban
authors.forename: José M
authors.initials: JM
authors.lastname: Bellón
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D004359:Drug Therapy, Combination; D054459:Elasticity Imaging Techniques; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D012254:Ribavirin / Q000627:therapeutic use*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons; D000410:Alanine Transaminase