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- Title
Sustained Virological Response to Interferon Plus Ribavirin Reduces Non–Liver-Related Mortality in Patients Coinfected With HIV and Hepatitis C Virus.
- Authors
Berenguer, Juan; Rodríguez, Elena; Miralles, Pilar; Von Wichmann, Miguel A.; López-Aldeguer, José; Mallolas, Josep; Galindo, María J.; Van Den Eynde, Eva; Téllez, María J.; Quereda, Carmen; Jou, Antoni; Sanz, José; Barros, Carlos; Santos, Ignacio; Pulido, Federico; Guardiola, Josep M.; Ortega, Enrique; Rubio, Rafael; Jusdado, Juan J.; Montes, María L.
- Abstract
We observed that eradication of hepatitis C virus in patients coinfected with human immunodeficiency virus (HIV) was associated not only with a reduction in liver-related complications and mortality but also with a reduction in the progression of HIV infection and mortality not related to liver disease.Background. Sustained virological response (SVR) after therapy with interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). We assessed the effect of SVR on HIV progression and mortality not related to liver disease.Methods. An observational cohort study including consecutive HIV/HCV-coinfected patients treated with interferon plus ribavirin between 2000 and 2008 in 19 centers in Spain.Results. Of 1599 patients, 626 (39%) had an SVR. After a median follow-up of approximately 5 years, we confirmed that failure to achieve an SVR was associated with an increased risk of liver-related events and liver-related death. We also observed higher rates of the following events in nonresponders than in responders: AIDS-defining conditions (rate per 100 person years, 0.84 [95% confidence interval (CI), .59–1.10] vs 0.29 [.10–.48]; P= .003), non–liver-related deaths (0.65 [.42–.87] vs 0.16 [.02–.30]; P = .002), and non–liver-related, non–AIDS-related deaths (0.55 [.34–.75] vs 0.16 [.02–.30]; P = .002). Cox regression analysis showed that the adjusted hazard ratios of new AIDS-defining conditions, non–liver-related deaths, and non–liver-related, non–AIDS-related deaths for nonresponders compared with responders were 1.90 (95% CI, .89–4.10; P = .095), 3.19 (1.21–8.40; P = .019), and 2.85 (1.07–7.60; P = .036), respectively.Conclusions. Our findings suggest that eradication of HCV after therapy with interferon plus ribavirin in HIV/HCV-coinfected patients is associated not only with a reduction in liver-related events but also with a reduction in HIV progression and mortality not related to liver disease.
- Subjects
HEPATITIS C virus; MORTALITY; LIVER diseases; INTERFERONS; RIBAVIRIN; COHORT analysis; REGRESSION analysis; CONFIDENCE intervals
- Publication
Clinical Infectious Diseases, 2012, Vol 55, Issue 5, p728
- ISSN
1058-4838
- Publication type
Article