title: Similar effectiveness of direct-acting antiviral against hepatitis C virus in patients with and without HIV infection.
abstract: We compared the baseline characteristics, effectiveness, and tolerance of direct-acting antiviral drug (DAA)-based regimens taken by hepatitis C virus (HCV)-monoinfected and HCV/HIV-coinfected individuals in clinical practice.
  
  
  
  We performed a prospective observational study in two tertiary centres in Madrid, Spain, which included all HCV-monoinfected and HCV/HIV-coinfected patients undergoing HCV treatment with all-oral DAA regimens in a routine clinical setting, from April 2015 to November 2015. We evaluated sustained virological response 12 weeks after the end of therapy (SVR12), adverse events, and baseline and treatment characteristics.
  
  
  
  The study population comprised 1634 patients: 1152 HCV-monoinfected patients (70%) and 482 HCV/HIV-coinfected patients (30%). Fifty percent had cirrhosis, and 47% were peginterferon/ribavirin-experienced. HCV/HIV-coinfected patients were younger [median age (interquartile range) 51 (48-54) years vs. 59 (50-68) years; P < 0.001), more frequently male (76 vs. 54%; P < 0.001), and infected with genotypes 1a (37 vs. 17%; P < 0.001), 3 (15 vs. 7%; P < 0.001), and 4 (23 vs. 4%; P < 0.001). One of every three patients took ribavirin. SVR12 was 94% (95% confidence interval 91.7-96%) and 97% (95% confidence interval 95.7-99.4%) in coinfected and monoinfected patients, respectively, with no significant differences between the groups after adjustment for cirrhosis, genotype, and DAA combination. DAA-based regimens were well tolerated, and only 1% of patients had severe adverse events, with no differences between the populations.
  
  
  
  HCV/HIV-infected patients treated with all-oral DAA combinations achieved high rates of SVR12 that were similar to those of HCV-monoinfected patients under real-life conditions. Safety and tolerance were excellent, even in patients with end-stage liver disease.
authors.affiliation: aUnidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPaz bUnidad de Hepatología, Servicio de Digestivo, Hospital Universitario La Paz, CIBERehd cUnidad de Hepatología, Servicio de Digestivo, Hospital General Universitario Gregorio Marañón, CIBERehd dUnidad VIH, Servicio de Enfermedades Infecciosas. Hospital General Universitario Gregorio Marañón, Instituto Investigación Sanitaria Gregorio Marañón (iSGM), Madrid, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Montes
authors.forename: Antonio
authors.initials: A
authors.lastname: Olveira
authors.forename: Adriana
authors.initials: A
authors.lastname: Ahumada
authors.forename: Teresa
authors.initials: T
authors.lastname: Aldámiz
authors.forename: Javier
authors.initials: J
authors.lastname: García-Samaniego
authors.forename: Ana
authors.initials: A
authors.lastname: Clemente
authors.forename: Juan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Juan
authors.initials: J
authors.lastname: González-García
authors.forename: Luz
authors.initials: L
authors.lastname: Martín-Carbonero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D000072230:Sustained Virologic Response; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents