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Impact of HIV infection on sustained virological response to treatment against hepatitis C virus with pegylated interferon plus ribavirin

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Abstract

It is commonly accepted that human immunodeficiency (HIV) coinfection negatively impacts on the rates of sustained virological response (SVR) to therapy with pegylated interferon plus ribavirin (PR). However, this hypothesis is derived from comparing different studies. The aim of this study was to determine the impact of HIV coinfection on SVR to PR in one single population. In a multicentric, prospective study conducted between 2000 and 2013, all previously naïve hepatitis C virus (HCV)-infected patients who started PR in five Spanish hospitals were analyzed. SVR was evaluated 24 weeks after the scheduled end of therapy. Of the 1046 patients included in this study, 413 (39 %) were coinfected with HIV. Three hundred and forty-one (54 %) HCV-monoinfected versus 174 (42 %) HIV/HCV-coinfected patients achieved SVR (p < 0.001). The corresponding figures for undetectable HCV RNA at treatment week 4 were 86/181 (47 %) versus 59/197 (30 %), p < 0.001. SVR was observed in 149 (69 %) HCV genotype 2/3-monoinfected subjects versus 91 (68 %) HIV/HCV genotype 2/3-coinfected subjects (p = 0.785). In the HCV genotype 1/4-infected population, 188 (46 %) monoinfected patients versus 82 (30 %) with HIV coinfection (p < 0.001) achieved SVR. In this subgroup, absence of HIV coinfection was independently associated with higher SVR [adjusted odds ratio (95 % confidence interval): 2.127 (1.135–3.988); p = 0.019] in a multivariate analysis adjusted for age, sex, baseline HCV RNA load, IL28B genotype, fibrosis stage, and type of pegylated interferon. HIV coinfection impacts on the rates of SVR to PR only in HCV genotype 1/4-infected patients, while it has no effect on SVR in the HCV genotype 2/3-infected subpopulation.

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Acknowledgments

This work was supported by the Red de Investigación en SIDA (ISCIII-RETIC RD06/006 and ISCIII-RETIC RD12/0017) and the Consejería de Salud of the Junta de Andalucía (grant numbers PI-0492/2012 and AC-0095-2013). K.N. is the recipient of a Miguel Servet research grant from the Instituto de Salud Carlos III (grant number CP13/00187). J.A.P. is the recipient of an intensification grant from the Instituto de Salud Carlos III (grant number Programa-I3SNS).

Conflict of interest

A.C.-I. has received speaker honorarium from Janssen, Gilead, and AbbVie laboratories. She has lead consultation activities to AbbVie, Gilead, Janssen, and Merck laboratories, and has taken part as advisory committees to AbbVie, ViiH, and Janssen. K.N. has received lecture fees from Janssen-Cilag, Roche, Bristol-Meyers Squibb, and Merck Sharp & Dohme, and has received research support from Janssen-Cilag, Bristol-Meyers Squibb, Merck Sharp & Dohme, Gilead Sciences, and Abbott Pharmaceuticals. J.A.P. reports having received consulting fees from GlaxoSmithKline, Bristol-Myers Squibb, Abbott Pharmaceuticals, Gilead, Merck Sharp & Dohme, Schering-Plough, Janssen-Cilag, and Boehringer Ingelheim. He has received research support from GlaxoSmithKline, Roche, Bristol-Myers Squibb, Schering-Plough, Abbott Pharmaceuticals, and Boehringer Ingelheim, and has received lecture fees from GlaxoSmithKline, Roche, Abbott Pharmaceuticals, Bristol-Myers Squibb, Gilead, Merck Sharp & Dohme, Janssen-Cilag, Boehringer Ingelheim, and Schering-Plough. A.R. has received consultancy fees from Abbott Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, ViiV Healthcare, and Gilead Sciences. M.D.M. has received speaker and/or consulting fees from Gilead Sciences, Bristol, Janssen, and AbbVie. J.M. has been an investigator in clinical trials supported by Roche, Bristol-Myers Squibb, and Abbott Pharmaceuticals. He has received lecture fees from Roche, Gilead, Boehringer Ingelheim, and Bristol-Myers Squibb, and consulting fees from Boehringer Ingelheim, Bristol Myers-Squibb, and Merck Sharp & Dome.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical committee of Valme Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda de Bellavista s/n, 41014, Sevilla, Spain

    P. Monje-Agudo, L. M. Real, N. Merchante, J. Macías, K. Neukam & J. A. Pineda

  2. Clinical Virology Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidad de A Coruña, 15006, A Coruña, Spain

    A. Castro-Iglesias, B. Pernas, P. Cid & A. Mena

  3. Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Avda Menéndez Pidal s/n, 14004, Córdoba, Spain

    A. Rivero-Juárez & A. Rivero

  4. Unit of Infectious Diseases, Complejo Hospitalario de Huelva, Ronda Exterior Norte s/n, 21005, Huelva, Spain

    F. Martínez-Marcos & M. D. Merino

  5. Unit of Infectious Diseases, Consorcio Hospital General Universitario de Valencia, Av. Tres Cruces s/n, 46014, Valencia, Spain

    E. Ortega-González

Authors
  1. P. Monje-Agudo
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  2. A. Castro-Iglesias
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  3. A. Rivero-Juárez
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  4. F. Martínez-Marcos
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  5. E. Ortega-González
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  6. L. M. Real
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  7. B. Pernas
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  8. N. Merchante
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  9. P. Cid
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  10. J. Macías
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  11. M. D. Merino
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  12. A. Rivero
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  13. A. Mena
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  14. K. Neukam
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  15. J. A. Pineda
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Consortia

from the Grupo de Estudio de Hepatitis Vírica, of the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica: GEHEP-SEIMC

Corresponding author

Correspondence to K. Neukam.

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Monje-Agudo, P., Castro-Iglesias, A., Rivero-Juárez, A. et al. Impact of HIV infection on sustained virological response to treatment against hepatitis C virus with pegylated interferon plus ribavirin. Eur J Clin Microbiol Infect Dis 34, 1929–1936 (2015). https://doi.org/10.1007/s10096-015-2434-6

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  • DOI: https://doi.org/10.1007/s10096-015-2434-6

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