Antonio Rivero-Juarez1, Karin Neukam2, Pablo Labarga3, Angela Camacho1, Juan Macias2, Pablo Barreiro3, Julián Torre-Cisneros1, Juan A Pineda3, Vicente Soriano2, Antonio Rivero4. 1. Unit of Infectious Diseases, Instituto Maimonides de Investigación Biomedica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Cordoba, Spain. 2. Unit of Infectious Diseases and Microbiology, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Seville 41014, Spain. 3. Department of Infectious Diseases, Hospital Carlos III, Madrid 28029, Spain. 4. Unit of Infectious Diseases, Instituto Maimonides de Investigación Biomedica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Cordoba, Spain. Electronic address: ariveror@gmail.com.
Abstract
OBJECTIVE: It is not known whether the probability of achieving sustained virological response (SVR) can be determined on the basis of the magnitude of HCV viral decline over the first 4 weeks of Peg-IFN/RBV treatment of HIV/HCV co-infected patients who fail to achieve a rapid virological response (RVR). METHODS: HIV patients co-infected with HCV genotype 1 naïve to Peg-IFN/RBV treatment were included. HCV viral decline from baseline to week 4 was graded. The positive predictive value (PPV) for SVR was evaluated according to the magnitude of HCV viral decline at week 4. RESULTS: One hundred and fifty patients were included. Thirty-four (22.6%) patients achieved RVR, 33 of these (PPV [CI 95%]; 97.05% [86.34-99.85]) achieved SVR. In those patients who did not achieve RVR, the probability to achieving SVR was graded according to the magnitude of viral decline at week 4 (>2 log10 [55.5%], >2.5 log10 [73.3%] and >3 log10 [75%]). The combination of undetectable and magnitude of decline (>2.5 log10) had a PPV for SVR of 89.8% (CI 95%; 0.794-0.964). CONCLUSIONS: The combination of undetectable HCV viral load and magnitude of decline at week 4 has a high PPV for SVR and identified a higher number of potential Peg-IFN/RBV responders.
OBJECTIVE: It is not known whether the probability of achieving sustained virological response (SVR) can be determined on the basis of the magnitude of HCV viral decline over the first 4 weeks of Peg-IFN/RBV treatment of HIV/HCV co-infectedpatients who fail to achieve a rapid virological response (RVR). METHODS:HIVpatients co-infected with HCV genotype 1 naïve to Peg-IFN/RBV treatment were included. HCV viral decline from baseline to week 4 was graded. The positive predictive value (PPV) for SVR was evaluated according to the magnitude of HCV viral decline at week 4. RESULTS: One hundred and fifty patients were included. Thirty-four (22.6%) patients achieved RVR, 33 of these (PPV [CI 95%]; 97.05% [86.34-99.85]) achieved SVR. In those patients who did not achieve RVR, the probability to achieving SVR was graded according to the magnitude of viral decline at week 4 (>2 log10 [55.5%], >2.5 log10 [73.3%] and >3 log10 [75%]). The combination of undetectable and magnitude of decline (>2.5 log10) had a PPV for SVR of 89.8% (CI 95%; 0.794-0.964). CONCLUSIONS: The combination of undetectable HCV viral load and magnitude of decline at week 4 has a high PPV for SVR and identified a higher number of potential Peg-IFN/RBV responders.
Authors: Antonio Rivero-Juarez; Luis F López-Cortés; Angela Camacho; Almudena Torres-Cornejo; Ana Gordon; Rosa Ruiz-Valderas; Julian Torre-Cisneros; Juan A Pineda; Pompeyo Viciana; Antonio Rivero Journal: PLoS One Date: 2014-06-19 Impact factor: 3.240