HIV-coinfected patients respond worse to direct-acting antiviral-based therapy against chronic hepatitis C in real life than HCV-monoinfected individuals: a prospective cohort study

Fecha de publicación: 01/05/2017

Autores de IIS La Fe

Marta Montero Alonso

Autor

Participantes ajenos a IIS La Fe

Neukam, K
Morano-Amado, LE
Rivero-Juarez, A
Mancebo, M
Granados, R
Tellez, F
Collado, A
Rios, MJ
de los Santos-Gil, I
Reus-Banuls, S
Vera-Mendez, F
Geijo-Martinez, P
Suarez-Santamaria, M
Pineda, JA

Grupos

Investigacion clínica en enfermedades crónicas e Infección por el VIH

Investigador establecido

Marta Montero Alonso

Abstract

Objective: HIV/HCV-coinfected patients and hepatitis C virus (HCV) monoinfected subjects are thought to respond equally to direct-acting antiviral (DAA)-based therapy despite the lack of data derived from clinical trials. This study is aimed to evaluate the impact of HIV coinfection on the response to DAA-based treatment against HCV infection in the clinical practice. Patients and Methods: In a prospective multicohort study, patients who initiated DAA-based therapy at the Infectious Disease Units of 33 hospitals throughout Spain were included. The primary efficacy outcome variables were the achievement of sustained virologic response 12 weeks after the scheduled end of therapy date (SVR12). Results: A total of 908 individuals had reached the SVR12 evaluation time-point, 426 (46.9%) were HIV/HCV-coinfected, and 472 (52%) received interferon (IFN)-free therapy. In an intention-to-treat analysis, SVR12 rates in subjects with and without HIV-coinfection were 55.3% (94/170 patients) versus 67.3% (179/266 subjects; p = 0.012) for IFN-based treatment and 86.3% (221/256 subjects) versus 94.9% (205/216 patients, p = 0.002) for IFN-free regimens. Relapse after end-of-treatment response to IFN-free therapy was observed in 3/208 (1.4%) HCV-monoinfected subjects and 10/231 (4.4%) HIV/HCV-coinfected individuals (p = 0.075). In a multivariate analysis adjusted for age, sex, transmission route, body-mass index, HCV genotype, and cirrhosis, the absence of HIV-coinfection (adjusted odds ratio: 3.367; 95% confidence interval: 1.15-9.854; p = 0.027) was independently associated with SVR12 to IFN-free therapy. Conclusions: HIV-coinfection is associated with worse response to DAA-based therapy against HCV infection. In patients receiving IFN-free therapy, this fact seems to be mainly driven by a higher rate of relapses among HIV-coinfected subjects.

Datos de la publicación

ISSN/ISSNe:: 1528-4336, 1945-5771
Tipo:: Article
Páginas:: 126-134
DOI:: 10.1080/15284336.2017.1330801
Factor de Impacto:: 0,707 SCImago ℠
Cuartil:: Q2 SCImago ℠

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Métricas

Filiaciones

Neukam, K:: a Unit of Infectious Diseases and Microbiology , Hospital Universitario de Valme , Seville , Spain

b Instituto de Biomedicina de Sevilla (IBiS) , Seville , Spain

Hosp Univ Valme, Unit Infect Dis & Microbiol, Ave Bellavista S-N, Seville 41014, Spain

Inst Biomed Sevilla IBIS, Seville, Spain
Morano-Amado, LE:: c Unit of Infectious Pathology , Hospital Universitario Alvaro Cunqueiro , Vigo , Spain

Hosp Univ Alvaro Cunqueiro, Unit Infect Pathol, Vigo, Spain
Rivero-Juarez, A:: d Unit of Infectious Diseases , Hospital Universitario Reina Sofía, Maimónides Institute of Biomedical Investigation(IMIBIC), University of Cordoba , Cordoba , Spain

Univ Cordoba, Hosp Univ Reina Sofia, Maimonides Inst Biomed Invest IMIBIC, Unit Infect Dis, Cordoba, Spain
Mancebo, M:: a Unit of Infectious Diseases and Microbiology , Hospital Universitario de Valme , Seville , Spain

b Instituto de Biomedicina de Sevilla (IBiS) , Seville , Spain

Hosp Univ Valme, Unit Infect Dis & Microbiol, Ave Bellavista S-N, Seville 41014, Spain

Inst Biomed Sevilla IBIS, Seville, Spain
Granados, R:: e Unit of Infectious Diseases , Hospital Universitario de Gran Canaria Dr Negrín , Las Palmas de Gran Canaria , Spain

Hosp Univ Gran Canaria Dr Negrin, Unit Infect Dis, Las Palmas Gran Canaria, Spain
Tellez, F:: f Unit of Infectious Diseases , Hospital La Línea, AGS Campo de Gibraltar , La Linea de la Concepcion , Spain

Hosp La Linea, AGS Campo Gibraltar, Unit Infect Dis, La Linea De La Concepcio, Spain
Collado, A:: g Infectious Diseases Unit , Hospital Universitario Torrecárdenas , Almeria , Spain

Hosp Univ Torrecardenas, Infect Dis Unit, Almeria, Spain
Rios, MJ:: h Unit of Infectious Diseases , Hospital Virgen Macarena , Seville , Spain

Hosp Virgen Macarena, Unit Infect Dis, Seville, Spain
de los Santos-Gil, I:: i Infectious Diseases Unit , Hospital Universitario La Princesa , Madrid , Spain

Hosp Univ La Princesa, Infect Dis Unit, Madrid, Spain
Reus-Banuls, S:: j Unit of Infectious Diseases , Hospital General Universitario de Alicante , Alicante , Spain

Hosp Gen Univ Alicante, Unit Infect Dis, Alicante, Spain
Vera-Mendez, F:: k Section of Infectious Medicine/Service of Internal Medicine , Hospital General Universitario Santa Lucía , Cartagena , Spain

Hosp Gen Univ Santa Lucia, Serv Internal Med, Sect Infect Med, Cartagena, Spain
Geijo-Martinez, P:: l Unit of Infectious Diseases , Hospital Virgen de la Luz , Cuenca , Spain

Hosp Virgen la Luz, Unit Infect Dis, Cuenca, Spain
Montero-Alonso, M:: m Unit of Infectious Diseases , Hospital Universitario y Politécnico La Fe , Valencia , Spain

Hosp Univ & Politecn La Fe, Unit Infect Dis, Valencia, Spain
Suarez-Santamaria, M:: n Fundación Biomédica del Complejo Hospitalario Universitario de Vigo (CHUVI) , Vigo , Spain

Complejo Hosp Univ Vigo CHUVI, Fdn Biomed, Vigo, Spain
Pineda, JA:: a Unit of Infectious Diseases and Microbiology , Hospital Universitario de Valme , Seville , Spain

Hosp Univ Valme, Unit Infect Dis & Microbiol, Ave Bellavista S-N, Seville 41014, Spain