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Baseline risk factors for relapse in HIV/HCV co-infected patients treated with PEG-IFN/RBV

  • Clinical and Epidemiological Study
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Abstract

Purpose

Hepatitis C virus (HCV) viral relapse (VR) after end-of-treatment response (ETR) in human immunodeficiency virus (HIV) co-infected patients is observed in as many as one in three co-infected patients. The aim of the study was to identify baseline risk factors for VR in HIV/HCV co-infected patients treated with pegylated interferon plus ribavirin (PEG-INF/RBV).

Methods

A total of 212 Caucasian HIV-infected patients with chronic hepatitis C naïve for PEG-INF/RBV were followed prospectively. Patients were included in this prospective study if they had completed a full course of therapy with an ETR. We assessed the relationship between VR rate and potential predictors of relapse.

Results

Of the patients followed, 130 (61.3 %) attained ETR and 103 (79.2 %) achieved sustained virological response (SVR). Consequently, 27 (20.8 %) showed VR. Patients who relapsed were more often male (p = 0.036), carried the non-CC rs14158 genotype in the low-density lipoprotein receptor (LDLr) gene (p = 0.039), had higher baseline HCV RNA levels (p = 0.012), body mass index (BMI) ≥25 kg/m2 (p = 0.034), significant liver fibrosis (p < 0.001), had been diagnosed with acquired immunodeficiency syndrome (AIDS)-defining criteria in the past (p = 0.001) and bore the HCV genotypes 1/4 (p = 0.046) when compared with SVR patients. The IL28B genotype was not associated with relapse. Multivariate binary logistic regression showed that high baseline HCV RNA, significant liver fibrosis, HCV genotypes 1/4, being overweight and being diagnosed with AIDS-defining criteria in the past were independently associated with relapse.

Conclusions

Our study shows that VR can be accurately predicted in HIV/HCV co-infected patients on the basis of risk factors which can be identified before treatment.

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Acknowledgments

This work was partly supported by grants from the Fundación Progreso y Salud, Consejería de Salud de la Junta de Andalucía (grants for health research projects, references: 0036/2010, PI-0247-2010 and PI-0208 and 0124/2008) and the Spanish Health Ministry (ISCIII-RETIC RD06/006, and projects PI10/0164 and PI10/01232). A.R. is the recipient of a research extension grant from the Fundación Progreso y Salud, Consejería de Salud de la Junta de Andalucía (reference AI-0011-2010), J.A.P. is the recipient of an extension grant from the Fundación Progreso y Salud of the Consejería de Salud de la Junta de Andalucía (reference AI-0021) and K.N. is the recipient of a Sara Borrell postdoctoral perfection grant from the Instituto de Salud Carlos III (SCO/523/2008).

Conflict of interest

The authors have no conflicts of interest to declare. A.R. has received consulting fees from Bristol-Myers Squibb, Abbott, Gilead, Roche and Boehringer Ingelheim. J.A.P. has received consulting fees from GlaxoSmithKline, Bristol-Myers Squibb, Abbott, Gilead, Merck Sharp & Dohme, Janssen-Cilag and Boehringer Ingelheim. They have received research support from GlaxoSmithKline, Roche, Bristol-Myers Squibb, Schering-Plough, Abbott and Boehringer Ingelheim, and lecture fees from GlaxoSmithKline, Roche, Abbott, Bristol-Myers Squibb, Boehringer Ingelheim and Schering-Plough. The remaining authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Unidad de Enfermedades Infecciosas, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Córdoba, Spain

    A. Rivero-Juarez, A. Camacho, J. Torre-Cisneros & A. Rivero

  2. Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de Valme, Sevilla, Spain

    J. A. Mira, K. Neukam, J. Macias & J. A. Pineda

  3. Hospital de Poniente, El Ejido, Almería, Spain

    I. Perez-Camacho

  4. Departamento de Biología Molecular, Universidad de Jaen, Jaén, Spain

    A. Caruz

Authors
  1. A. Rivero-Juarez
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  2. J. A. Mira
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  3. A. Camacho
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  4. K. Neukam
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  5. I. Perez-Camacho
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  6. A. Caruz
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  7. J. Macias
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  8. J. Torre-Cisneros
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  9. J. A. Pineda
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  10. A. Rivero
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Corresponding authors

Correspondence to A. Rivero-Juarez or A. Rivero.

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Rivero-Juarez, A., Mira, J.A., Camacho, A. et al. Baseline risk factors for relapse in HIV/HCV co-infected patients treated with PEG-IFN/RBV. Infection 41, 21–26 (2013). https://doi.org/10.1007/s15010-012-0352-4

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  • DOI: https://doi.org/10.1007/s15010-012-0352-4

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