June 12, 2013

Provided by Healio

Berenguer J. J Hepatol. 2013;58:1104-1112.

June 12, 2013

Patients with HCV/HIV coinfection who experienced viral relapse after treatment with interferon-based therapy still experienced some clinical benefit, according to recent results.

Researchers evaluated 1,599 patients enrolled in the GESIDA 3603 cohort, which includes patients coinfected with HCV and HIV, and treated with interferon and ribavirin at 19 Spanish medical facilities. Incidence of mortality and liver-related complications was observed from completion of therapy to death or last follow-up visit (median 4 years).

Sustained virologic response (SVR) at 24 weeks post-treatment occurred in 584 patients, 765 participants experienced no response, and 250 relapsed after end-of-treatment response. Multiple logistic regression analysis indicated associations between SVR and receipt of pegylated interferon (OR=1.64; 95% CI, 1.08-2.51), an HCV RNA level less than 500,000 IU/mL (OR=1.75; 95% CI, 1.31-2.33), lack of advanced fibrosis (OR=1.84; 95% CI, 1.38-2.46), daily alcohol intake below 50 g (OR=2.17; 95% CI, 1.07-4.42) and HCV genotype 2 or 3 (OR=4.41; 95% CI, 3.34-5.82).

Patients who experienced SVR had significantly lower overall, liver-related, AIDS-related and non-AIDS, nonliver-related mortality rates compared with the other groups. Relapsers had significantly lower overall and liver-related mortality rates than nonresponders. Similarly, risk for liver-related events (decompensation, hepatocellular carcinoma, liver transplantation and liver-related death) was lowest in the SVR group, and significantly lower among relapsers than nonresponders.

Compared with nonresponders, SVR patients had an adjusted HR of 0.03 (95% CI, 0-0.2) for liver-related events, while relapsers had an aHR of 0.17 (95% CI, 0.05-0.5). Liver stiffness was least among the SVR group, and relapsers displayed less liver stiffness than nonresponders.

“The findings of this study suggest that, in patients coinfected with HIV/HCV, viral relapse after anti-HCV treatment provides some clinical benefits; not as good as those obtained with SVR, but clearly higher than those obtained by nonresponders,” researcher Juan Berenguer, MD, infectious diseases and HIV unit at Hospital General Universitario Gregorio Marañón in Madrid, said in a release. “In our view, these data should be a source of optimism for patients who relapse after anti-HCV treatment is discontinued, because the efforts and resource invested in treatment have not been in vain.”

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