title: Impact of HIV infection on sustained virological response to treatment against hepatitis C virus with pegylated interferon plus ribavirin.
abstract: It is commonly accepted that human immunodeficiency (HIV) coinfection negatively impacts on the rates of sustained virological response (SVR) to therapy with pegylated interferon plus ribavirin (PR). However, this hypothesis is derived from comparing different studies. The aim of this study was to determine the impact of HIV coinfection on SVR to PR in one single population. In a multicentric, prospective study conducted between 2000 and 2013, all previously naïve hepatitis C virus (HCV)-infected patients who started PR in five Spanish hospitals were analyzed. SVR was evaluated 24 weeks after the scheduled end of therapy. Of the 1046 patients included in this study, 413 (39%) were coinfected with HIV. Three hundred and forty-one (54%) HCV-monoinfected versus 174 (42%) HIV/HCV-coinfected patients achieved SVR (p < 0.001). The corresponding figures for undetectable HCV RNA at treatment week 4 were 86/181 (47%) versus 59/197 (30%), p < 0.001. SVR was observed in 149 (69%) HCV genotype 2/3-monoinfected subjects versus 91 (68%) HIV/HCV genotype 2/3-coinfected subjects (p = 0.785). In the HCV genotype 1/4-infected population, 188 (46%) monoinfected patients versus 82 (30%) with HIV coinfection (p < 0.001) achieved SVR. In this subgroup, absence of HIV coinfection was independently associated with higher SVR [adjusted odds ratio (95% confidence interval): 2.127 (1.135-3.988); p = 0.019] in a multivariate analysis adjusted for age, sex, baseline HCV RNA load, IL28B genotype, fibrosis stage, and type of pegylated interferon. HIV coinfection impacts on the rates of SVR to PR only in HCV genotype 1/4-infected patients, while it has no effect on SVR in the HCV genotype 2/3-infected subpopulation.
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Monje-Agudo
authors.affiliation: Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidad de A Coruña, 15006, A Coruña, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Castro-Iglesias
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Avda Menéndez Pidal s/n, 14004, Córdoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rivero-Juárez
authors.affiliation: Unit of Infectious Diseases, Complejo Hospitalario de Huelva, Ronda Exterior Norte s/n, 21005, Huelva, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Martínez-Marcos
authors.affiliation: Unit of Infectious Diseases, Consorcio Hospital General Universitario de Valencia, Av. Tres Cruces s/n, 46014, Valencia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ortega-González
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain.
authors.forename: L M
authors.initials: LM
authors.lastname: Real
authors.affiliation: Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidad de A Coruña, 15006, A Coruña, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Pernas
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Merchante
authors.affiliation: Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidad de A Coruña, 15006, A Coruña, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Cid
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Macías
authors.affiliation: Unit of Infectious Diseases, Complejo Hospitalario de Huelva, Ronda Exterior Norte s/n, 21005, Huelva, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Merino
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Avda Menéndez Pidal s/n, 14004, Córdoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rivero
authors.affiliation: Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidad de A Coruña, 15006, A Coruña, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Mena
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain. karin.neukam@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Neukam
authors.affiliation: Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D013030:Spain; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin