Abstract
Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries. To know the impact of such medications in the sustained virological response (SVR) during HCV treatment is of great importance. This was a retrospective cohort study of 215 coinfected HIV/HCV patients. The patients were treated with PEG-IFN and RBV between 2007 and 2013 and analyzed by intention to treat. Treatment-experienced patients to HCV and carriers of hepatitis B were excluded. Demographic data (gender, age), mode of infection, HCV genotype, HCV viral load, hepatic fibrosis, HIV status, and type of PEG were evaluated. One hundred eighty-eight (87.4%) patients were using HAART. SVR was achieved in 55 (29.3%) patients using HAART and in 9 (33.3%) patients not using HAART (p = 0.86). There was no difference in SVR between different HAART medications and regimens using two reverse transcriptase inhibitor nucleosides (NRTIs) or the use of protease inhibitors and non-NRTIs (27.1% versus 31.5%; p = 0.61). The predictive factors for obtaining SVR were low HCV viral load, non-1 genotype, and the use of peginterferon-α2a. The use of HAART does not influence the SVR of HCV under PEG-IFN and RBV therapy in HIV/HCV coinfected patients.
Highlights
Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries
It has been reported that the progression of chronic hepatitis to cirrhosis, liver failure, and the development of hepatocellular carcinoma could be accelerated in coinfected HIV/HCV patients [8,9,10], since HIV can adversely affect all stages of the natural history of HCV
No difference was observed in sustained virological response (SVR) when comparing the use of protease inhibitor (PI) (26/96; 27.1%) and nucleoside reverse transcriptase inhibitors (NNRTIs) (29/92; 31.5%) (p = 0.61)
Summary
Many patients coinfected with the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are using highly active antiretroviral therapy (HAART) and HCV therapy with peginterferon (PEG-IFN) and ribavirina (RBV) because the use of direct-acting antivirals is not a reality in some countries. Conclusions: The use of HAART does not influence the SVR of HCV under PEG-IFN and RBV therapy in HIV/HCV coinfected patients. Chronic liver disease caused by HCV has become a major cause of morbidity and mortality in HIV-infected patients since the introduction of highly active antiretroviral therapy (HAART) in 1996 [5,6,7]. Other authors have demonstrated that the progression of liver disease in HIV/HCV coinfected patients occurs primarily when the HIV infection is inadequately managed [12,13]. Confirming this hypothesis, Tovo et al assessed 385 HIV/HCV coinfected patients, and observed a similar fibrosis progression rate to that of HCV or HIV monoinfected patients [14]
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