Interferon-free therapy for treating hepatitis C virus in difficult-to-treat HIV-coinfected patients

Fecha de publicación: 28/01/2018

Autores de IIS La Fe

Marta Montero Alonso

Autor

Participantes ajenos a IIS La Fe

Minguez, C
Garcia-Deltoro, M
Flores, J
Galindo, MJ
Reus, S
Carmena, J
Masia, M
Amador, C
Ortega, E
COINFECOVA-2 Study Grp

Grupos

Investigacion clínica en enfermedades crónicas e Infección por el VIH

Investigador establecido

Marta Montero Alonso

Abstract

Background/aims: Data regarding the use of all-oral direct-acting antivirals in HIV/hepatitis C virus (HCV)-coinfected patients with advanced liver fibrosis are required, because they are generally under-represented in clinical trials. This study sought to evaluate the use of these drugs in a cohort of coinfected patients, mostly with factors that have previously been recognized as predictors of treatment failure. Methods: COINFECOVA-2 is an observational, multicenter study conducted in Eastern Spain. Data of all HIV/HCV-coinfected patients treated with direct-acting antiviral under real-life conditions were retrospectively collected, and factors associated with treatment success or safety were analysed. Results: Among 515 included patients, 96% were on antiretroviral therapy and 89.5% had an HIV-RNA less than 50 copies/ml. HCV genotype (G) distribution was 47% G-1a, 20% G-4, 14.4% G-1b, and 12.8% G-3. Patients with cirrhosis were 54.2%, and 46% failed to prior HCV-therapies. Overall, 92.8% patients (95% confidence interval: 90.2-94.9) achieved sustained virologic response (SVR12). Cirrhosis was the only factor associated with treatment failure, and SVR12 rate was significantly lower in patients with liver stiffness at least 21 kPa. Adverse events were reported in 36.7%, but only two patients (0.4%) discontinued treatment because of adverse events. The bivariate analysis showed an association between ribavirin use and an increased risk of adverse events (odds ratio 2.84; 95% confidence interval: 1.95-4.1; P <= 0.0001). Conclusion: This heterogeneous cohort of coinfected patients showed a high rate of SVR12. Among cirrhotic patients, those with a liver stiffness at least 21 kPa had a higher probability of treatment failure. Ribavirin use seems to increase the appearance of adverse events. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:: 0269-9370, 1473-5571
Tipo:: Article
Páginas:: 337-346
DOI:: 10.1097/QAD.0000000000001699
Factor de Impacto:: 2,706 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Minguez, C:: Hosp Gen Univ Castellon, Internal Med Dept, Infect Dis Unit, Castellon De La Plana, Spain
Garcia-Deltoro, M:: Consorcio Hosp Gen Univ Valencia, Infect Dis Dept, Valencia, Spain
Flores, J:: Hosp Arnau Vilanova, Internal Med Dept, Lleida, Spain
Galindo, MJ:: Hosp Clin Univ, Infect Dis Unit, Internal Med Dept, Valencia, Spain
Montero, M:: Hosp Univ & Politecn La Fe, Internal Med Dept, Infect Dis Unit, Valencia, Spain
Reus, S:: Hosp Gen Univ Alicante, Internal Med Dept, Infect Dis Unit, Alicante, Spain
Carmena, J:: Hosp Univ Dr Peset, Infect Dis Unit, Internal Med Dept, Valencia, Spain
Masia, M:: Hosp Gen Univ Elche, Internal Med Dept, Infect Dis Unit, Elche, Spain
Amador, C:: Hosp Marina Baixa, Internal Med Dept, Infect Dis Unit, La Vila Joiosa, Spain
Ortega, E:: Consorcio Hosp Gen Univ Valencia, Infect Dis Dept, Valencia, Spain
COINFECOVA-2 Study Grp:: COINFECOVA-2 Study Grp