title: Association of baseline CD4+ cell count and HIV-RNA on sustained virologic response to interferon-ribavirin in HIV/HCV coinfected patients.
abstract: BACKGROUND AND RATIONALE FOR THE STUDY: We assessed the association of CD4+ T-cell counts and HIV-RNA on sustained viral response (SVR) after therapy with pegylated interferon and ribavirin (PR) in HIV/HCV coinfected patients. We examined two large cohorts of coinfected patients treated with PR in Spain between 2000 and 2008. SVR was defined as undetectable HCV-RNA at 24 weeks after the end of PR.
  
  
  RESULTS
  We studied 1682 patients, of whom 38% achieved SVR. Baseline factors independently associated with reduced odds of SVR included genotype 1 or 4, HCV-RNA > 500,000 IU/mL, advanced liver fibrosis, CDC clinical category C, and detectable HIV-RNA. By multivariate logistic regression analysis, we found that, in comparison with patients with combination antiretroviral therapy (cART) and undetectable HIV-RNA, the odds ratio [95% confidence interval (CI)] of SVR was 0.56 (0.41-0.78) for cART and detectable HIV-RNA, 0.86 (0.56-2.57) for no-cART and detectable HIV-RNA, and 1.38 (0.74-2.57) for no-cART and undetectable HIV-RNA.
  
  
  CONCLUSIONS
  Detectable HIV-RNA, but not CD4+ T-cell count, was associated with reduced odds of SVR. However, this finding was only confirmed for cART and detectable HIV-RNA, raising the question as whether this represents a true association of HIV-RNA on response to PR or a spurious association due to poor adherence to treatment.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Aldámiz-Echevarría
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.affiliation: Hospital Donostia, San Sebastián, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Von Wichmann
authors.affiliation: Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Crespo
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López-Aldeguer
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Téllez
authors.affiliation: Hospital Clínico Universitario, Valencia, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Galindo
authors.affiliation: Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sanz
authors.affiliation: Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Guardiola
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Bellón
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Montes
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D005838:Genotype; D006678:HIV / Q000187:drug effects / Q000235:genetics*; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood / Q000235:genetics*; D012189:Retrospective Studies; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons