Effects of Sustained Viral Response in Patients With HIV and Chronic Hepatitis C and Nonadvanced Liver Fibrosis

Autores de IIS La Fe

• Joaquin Berenguer Lapuerta

  Autor

• José López Aldeguer

  Autor

• Luis Aldamiz-Echevarria Azuara

  Autor

• María Jose Galindo Puerto

  Autor

Participantes ajenos a IIS La Fe

• Zamora FX
• Carrero A
• Von Wichmann MA
• Crespo M
• Montes M
• Quereda C
• Téllez MJ
• Sanz J
• Santos I
• Guardiola JM
• Esteban H
• Bellón JM
• González-García J
• GESIDA HIVHCV Cohort Study Group

Grupos

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador establecido

  Marta Montero Alonso

Abstract

Objective:We assessed the effects of sustained viral response (SVR), after treating with interferon-ribavirin (IF-RB), on mortality, liver-related (LR) events (decompensation, hepatocellular carcinoma), HIV progression, and liver stiffness in HIV/hepatitis C virus (HCV)-coinfected patients with nonadvanced liver fibrosis.Methods:From a cohort of HIV/HCV-coinfected patients treated with IF-RB, we selected those with baseline liver fibrosis stages F0, F1, or F2 according to METAVIR. The study started when IF-RB was stopped and ended at death or at the last follow-up visit.Results:A total of 695 patients were included (HCV genotype 1 or 4, 431; F0, 77; F1, 290; and F2, 328), and 274 patients achieved SVR. After a median follow-up of 4.9 years, the adjusted hazard ratio (aHR) [95% confidence interval (CI)] of LR events or overall death, for patients with SVR taking the group of patients with no SVR as a reference was 0.217 (0.079 to 0.599) (P = 0.003) for the whole cohort with F0 to F2. For patients with F0, the aHR (95% CI) was 0.514 (0.040 to 6.593) (P = 0.609), for patients with F1, the aHR (95% CI) was 0.305 (0.053 to 1.762) (P = 0.185), and for patients with F2, it was 0.075 (0.009 to 0.662) (P = 0.020). We also found that, in comparison with no SVR, SVR was followed by less frequent HIV progression for the entire population (F0 to F2) and less frequent liver stiffness across all categories of fibrosis.Conclusions:SVR in HIV/HCV-coinfected patients with moderate stages of liver fibrosis is associated with a reduction of mortality and LR events, and with a reduction of progression of HIV and liver fibrosis.

Keywords

• HIV infections; *complications; *drug therapy; hepatitis C; chronic; *complications; *drug therapy; interferons; administration and dosage; *therapeutic use; follow-up studies; treatment outcome