G N Ioannou1, J D Scott, Y Yang, P K Green, L A Beste. 1. Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA; Divisions of Gastroenterology, University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: The effectiveness of anti-viral treatment for hepatitis C virus (HCV) in HIV/HCV co-infected patients in 'real world', clinical practice is unclear. AIMS: To determine the rates and predictors of sustained virological response (SVR) to anti-viral treatment for HCV with pegylated interferon (PEG-IFN) and ribavirin in HIV/HCV co-infected patients. METHODS: We identified all HIV/HCV co-infected patients who received anti-viral treatment with PEG-IFN and ribavirin in the Veterans Affairs healthcare system nationally between 2002 and 2009 (n = 665). RESULTS: Sustained virological response was achieved in 21.6% overall, 16.7% among patients with genotype 1 HCV (n = 491) and 44% among patients with genotype 2 or 3 HCV (n = 116). Among genotype 1-infected patients, characteristics that were negatively associated with SVR independently included baseline HCV viral load >2 million IU/mL [adjusted odds ratio (AOR) 0.41, 95% CI 0.2-0.7], Black race [AOR 0.56 (0.3-0.96)], diabetes [AOR 0.42 (0.2-0.9)], baseline anaemia [AOR 0.42 (0.2-0.97)], serum aspartate aminotransferase/alanine aminotransferase ratio ≥1.2 [AOR 0.48 (0.2-0.97)] and use of zidovudine [AOR 0.41 (0.2-0.9)]; characteristics positively associated with SVR included a starting dose of ribavirin ≥1000-1200 mg/day [AOR 2.0 (1.1-3.7)] and erythropoietin use during treatment [AOR 2.9 (1.6-5.0)]. Among genotype 2 or 3 infected patients, only erythropoietin use was an independent predictor of SVR [AOR 3.1 (1.2-7.8)], while a starting dose of ribavirin >800 mg/day was not associated with SVR. CONCLUSIONS: Sustained virological response rates achieved with PEG-IFN and ribavirin in HIV/HCV co-infected patients are low in clinical practice. The use of erythropoietin was the most important, modifiable factor associated with SVR. Published 2013. This article is a US Government work and is in the public domain in the USA.
BACKGROUND: The effectiveness of anti-viral treatment for hepatitis C virus (HCV) in HIV/HCV co-infectedpatients in 'real world', clinical practice is unclear. AIMS: To determine the rates and predictors of sustained virological response (SVR) to anti-viral treatment for HCV with pegylated interferon (PEG-IFN) and ribavirin in HIV/HCV co-infectedpatients. METHODS: We identified all HIV/HCV co-infectedpatients who received anti-viral treatment with PEG-IFN and ribavirin in the Veterans Affairs healthcare system nationally between 2002 and 2009 (n = 665). RESULTS: Sustained virological response was achieved in 21.6% overall, 16.7% among patients with genotype 1 HCV (n = 491) and 44% among patients with genotype 2 or 3 HCV (n = 116). Among genotype 1-infectedpatients, characteristics that were negatively associated with SVR independently included baseline HCV viral load >2 million IU/mL [adjusted odds ratio (AOR) 0.41, 95% CI 0.2-0.7], Black race [AOR 0.56 (0.3-0.96)], diabetes [AOR 0.42 (0.2-0.9)], baseline anaemia [AOR 0.42 (0.2-0.97)], serum aspartate aminotransferase/alanine aminotransferase ratio ≥1.2 [AOR 0.48 (0.2-0.97)] and use of zidovudine [AOR 0.41 (0.2-0.9)]; characteristics positively associated with SVR included a starting dose of ribavirin ≥1000-1200 mg/day [AOR 2.0 (1.1-3.7)] and erythropoietin use during treatment [AOR 2.9 (1.6-5.0)]. Among genotype 2 or 3 infectedpatients, only erythropoietin use was an independent predictor of SVR [AOR 3.1 (1.2-7.8)], while a starting dose of ribavirin >800 mg/day was not associated with SVR. CONCLUSIONS: Sustained virological response rates achieved with PEG-IFN and ribavirin in HIV/HCV co-infectedpatients are low in clinical practice. The use of erythropoietin was the most important, modifiable factor associated with SVR. Published 2013. This article is a US Government work and is in the public domain in the USA.
Authors: Andrew M Moon; Noel S Weiss; Lauren A Beste; Feng Su; Samuel B Ho; Ga-Young Jin; Elliott Lowy; Kristin Berry; George N Ioannou Journal: Gastroenterology Date: 2018-07-05 Impact factor: 22.682
Authors: Bing Zhang; Nghia H Nguyen; Brittany E Yee; Benjamin Yip; Walid S Ayoub; Glen A Lutchman; Mindie H Nguyen Journal: Intervirology Date: 2015-09-25 Impact factor: 1.763
Authors: George N Ioannou; Lauren A Beste; Michael F Chang; Pamela K Green; Elliott Lowy; Judith I Tsui; Feng Su; Kristin Berry Journal: Gastroenterology Date: 2016-06-04 Impact factor: 22.682
Authors: Helen Kovari; Stefan Russmann; Bruno Ledergerber; Daniel Müller; Margalida Rotger; Pablo Velli; Matthias Cavassini; Juan Ambrosioni; Andrea Bregenzer; Marcel Stöckle; Enos Bernasconi; Andri Rauch; Roberto F Speck Journal: PLoS One Date: 2015-07-28 Impact factor: 3.240