title: Eradication of hepatitis C virus and non-liver-related non-acquired immune deficiency syndrome-related events in human immunodeficiency virus/hepatitis C virus coinfection.
abstract: We assessed non-liver-related non-acquired immunodeficiency syndrome (AIDS)-related (NLR-NAR) events and mortality in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with interferon (IFN) and ribavirin (RBV), between 2000 and 2008. The censoring date was May 31, 2014. Cox regression analysis was performed to assess the adjusted hazard rate (HR) of overall death in responders and nonresponders. Fine and Gray regression analysis was conducted to determine the adjusted subhazard rate (sHR) of NLR deaths and NLR-NAR events considering death as the competing risk. The NLR-NAR events analyzed included diabetes mellitus, chronic renal failure, cardiovascular events, NLR-NAR cancer, bone events, and non-AIDS-related infections. The variables for adjustment were age, sex, past AIDS, HIV transmission category, nadir CD4+T-cell count, antiretroviral therapy, HIV RNA, liver fibrosis, HCV genotype, and exposure to specific anti-HIV drugs. Of the 1,625 patients included, 592 (36%) had a sustained viral response (SVR). After a median 5-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR, 0.57; 95% confidence interval [CI], 0.35-0.93; P = 0.024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR, 0.43; 95% CI, 0.17-1.09; P = 0.075).
  
  
  
  Our data suggest that eradication of HCV in coinfected patients is associated not only with a reduction in the frequency of death, HIV progression, and liver-related events, but also with a reduced hazard of diabetes mellitus and possibly of chronic renal failure. These findings argue for the prescription of HCV therapy in coinfected patients regardless of fibrosis stage. (Hepatology 2017;66:344-356).
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
authors.affiliation: Hospital Universitario La Paz, Madrid/IdiPaz, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Rodríguez-Castellano
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain.|Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Carrero
authors.affiliation: Hospital Donostia, San Sebastián, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Von Wichmann
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Montero
authors.affiliation: Hospital Clínico Universitario, Valencia, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Galindo
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Mallolas
authors.affiliation: Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Crespo
authors.affiliation: Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Téllez
authors.affiliation: Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.affiliation: Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sanz
authors.affiliation: Hospital Universitario de Móstoles, Móstoles, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Barros
authors.affiliation: Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tural
authors.affiliation: Hospital Universitario de La Princesa, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Santos
authors.affiliation: Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Guardiola
authors.affiliation: Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio
authors.affiliation: Hospital General Universitario, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Ortega
authors.affiliation: Hospital Universitario La Paz, Madrid/IdiPaz, Spain.
authors.forename: María L
authors.initials: ML
authors.lastname: Montes
authors.affiliation: Hospital Universitario Severo Ochoa, Leganés, Spain.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Jusdado
authors.affiliation: Hospital Universitario de Getafe, Getafe, Spain.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gaspar
authors.affiliation: Fundación SEIMC-GESIDA, Madrid, Spain.
authors.forename: Herminia
authors.initials: H
authors.lastname: Esteban
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/IdiPaz, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000328:Adult; D015331:Cohort Studies; D060085:Coinfection / Q000188:drug therapy* / Q000503:physiopathology; D015897:Comorbidity; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000187:drug effects / Q000302:isolation & purification; D016174:Hepacivirus / Q000187:drug effects / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D018570:Risk Assessment; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha; D012254:Ribavirin