Mattias Mandorfer1, Karin Neukam, Thomas Reiberger, Berit A Payer, Antonio Rivero, Massimo Puoti, Christoph Boesecke, Axel Baumgarten, Anna Grzeszczuk, Robert Zangerle, Dirk Meyer-Olson, Jürgen K Rockstroh, Michael Trauner, Juan A Pineda, Markus Peck-Radosavljevic. 1. aDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria bUnit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville cDepartment of Infectious Diseases, Hospital Universitario Reina Sofía, Córdoba, Spain dDepartment of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy eDepartment of Internal Medicine I, University of Bonn, Bonn fPraxis Driesener Strasze, Berlin, Germany gDepartment of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland hDepartment of Dermatology, Medical University of Innsbruck, Innsbruck, Austria iDepartment of Clinical Immunology and Rheumatology, Medical University Hannover, Hannover, Germany.
Abstract
OBJECTIVE: According to the European AIDS Clinical Society (EACS) guidelines for response-guided therapy (RGT) of chronic hepatitis C virus (HCV) infection in HIV-positive patients, HCV-genotype (GT) and rapid virologic response (RVR) exclusively determine the duration of antiviral therapy with pegylated interferon and ribavirin (PEGIFN+RBV). The aim of this study was to investigate the impact of interleukin 28B rs12979860 single nucleotide polymorphism (IL28B) and liver fibrosis stage on RGT in HIV/HCV-coinfected patients. DESIGN: Four hundred and thirty HIV/HCV-coinfected patients treated with PEGIFN+RBV were included in this multinational, retrospective analysis. METHODS: Advanced liver fibrosis was defined as either METAVIR F3/F4 or liver stiffness more than 9.5 kPa. RESULTS: In patients with GT1/4 without RVR (GT1/4-noRVR), higher sustained virologic response (SVR) rates were observed in patients with extended treatment duration (48 weeks: 35% vs. 72 weeks: 60%; P = 0.008). In GT1/4-noRVR patients without advanced liver fibrosis (48 weeks: 45% vs. 72 weeks: 61%; P = 0.176), or with IL28B C/C (48 weeks: 48% vs. 72 weeks: 69%; P = 0.207), SVR rates did not vary significantly throughout the treatment duration subgroups. In contrast, in patients with advanced liver fibrosis (48 weeks: 11% vs. 72 weeks: 45%; P = 0.031), or IL28B non-C/C (48 weeks: 28% vs. 72 weeks: 56%; P = 0.011), extended treatment duration was associated with substantially higher SVR rates. GT2/3 patients with RVR (GT2/3-RVR) with shortened treatment duration (24 weeks) displayed SVR rates ranging from 83 to 100%, regardless of IL28B and liver fibrosis stage. CONCLUSION: Our study confirms the concept of RGT in HIV/HCV coinfection and supports the extension of therapy duration to 72 weeks for patients with GT1/4-noRVR, especially in patients with IL28B non-C/C or advanced liver fibrosis. The results of our study strongly support the shortening of therapy duration to 24 weeks in GT2/3-RVR patients, regardless of IL28B and advanced liver fibrosis.
OBJECTIVE: According to the European AIDS Clinical Society (EACS) guidelines for response-guided therapy (RGT) of chronic hepatitis C virus (HCV) infection in HIV-positivepatients, HCV-genotype (GT) and rapid virologic response (RVR) exclusively determine the duration of antiviral therapy with pegylated interferon and ribavirin (PEGIFN+RBV). The aim of this study was to investigate the impact of interleukin 28B rs12979860 single nucleotide polymorphism (IL28B) and liver fibrosis stage on RGT in HIV/HCV-coinfectedpatients. DESIGN: Four hundred and thirty HIV/HCV-coinfectedpatients treated with PEGIFN+RBV were included in this multinational, retrospective analysis. METHODS: Advanced liver fibrosis was defined as either METAVIR F3/F4 or liver stiffness more than 9.5 kPa. RESULTS: In patients with GT1/4 without RVR (GT1/4-noRVR), higher sustained virologic response (SVR) rates were observed in patients with extended treatment duration (48 weeks: 35% vs. 72 weeks: 60%; P = 0.008). In GT1/4-noRVR patients without advanced liver fibrosis (48 weeks: 45% vs. 72 weeks: 61%; P = 0.176), or with IL28B C/C (48 weeks: 48% vs. 72 weeks: 69%; P = 0.207), SVR rates did not vary significantly throughout the treatment duration subgroups. In contrast, in patients with advanced liver fibrosis (48 weeks: 11% vs. 72 weeks: 45%; P = 0.031), or IL28B non-C/C (48 weeks: 28% vs. 72 weeks: 56%; P = 0.011), extended treatment duration was associated with substantially higher SVR rates. GT2/3 patients with RVR (GT2/3-RVR) with shortened treatment duration (24 weeks) displayed SVR rates ranging from 83 to 100%, regardless of IL28B and liver fibrosis stage. CONCLUSION: Our study confirms the concept of RGT in HIV/HCV coinfection and supports the extension of therapy duration to 72 weeks for patients with GT1/4-noRVR, especially in patients with IL28B non-C/C or advanced liver fibrosis. The results of our study strongly support the shortening of therapy duration to 24 weeks in GT2/3-RVRpatients, regardless of IL28B and advanced liver fibrosis.
Authors: Luis M Real; Karin Neukam; Rocío Herrero; Josep M Guardiola; Thomas Reiberger; Antonio Rivero-Juarez; Juliana Salazar; Mattias Mandorfer; Dolores Merino; Vicente Soriano; Antonio Rivero; Juan Macías; Juan A Pineda; Antonio Caruz Journal: PLoS One Date: 2014-04-18 Impact factor: 3.240
Authors: Sara Corchado; Luis F López-Cortés; Antonio Rivero-Juárez; Almudena Torres-Cornejo; Antonio Rivero; Mercedes Márquez-Coello; José-Antonio Girón-González Journal: PLoS One Date: 2014-07-11 Impact factor: 3.240