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AIDS and Behavior

, Volume 17, Issue 1, pp 94–103 | Cite as

Adherence to Hepatitis C Virus Therapy in HIV/Hepatitis C-Coinfected Patients

  • Vincent Lo ReIIIEmail author
  • Valerie Teal
  • A. Russell Localio
  • Valerianna K. Amorosa
  • David E. Kaplan
  • Robert Gross
Original Paper

Abstract

Adherence to hepatitis C virus (HCV) therapy has been incompletely examined among HIV-infected patients. We assessed changes in interferon and ribavirin adherence and evaluated the relationship between adherence and early (EVR) and sustained virologic response (SVR). We performed a cohort study among 333 HIV/HCV-coinfected patients who received pegylated interferon and ribavirin between 2001 and 2006 and had HCV RNA before and after treatment. Adherence was calculated over 12-week intervals using pharmacy refills. Mean interferon and ribavirin adherence declined 2.5 and 4.1 percentage points per 12-week interval, respectively. Among genotype 1/4 patients, EVR increased with higher ribavirin adherence, but this association was less strong for interferon. SVR among these patients was higher with increasing interferon and ribavirin adherence over the first, second, and third, but not fourth, 12-week intervals. Among HIV/HCV patients, EVR and SVR increased with higher interferon and ribavirin adherence. Adherence to both antivirals declined over time, but more so for ribavirin.

Keywords

Adherence Hepatitis C virus HIV Antiviral therapy Pegylated interferon Ribavirin 

Abbreviations

EVR

Early virologic response

HCV

Hepatitis C virus

SVR

Sustained virologic response

VA

Veterans affairs

Resumen

La adhesión a la hepatitis C (HCV), la terapia ha sido completamente examinado entre pacientes infectados por HIV. Se evaluaron los cambios en el interferón y la ribavirina y la adhesión se evaluó la relación entre la adherencia y la respuesta virológica temprana (EVR) y sostenida (SVR). Se realizó un estudio de cohortes entre los 333 con HIV/HCV-coinfectados pacientes que recibieron interferón pegilado y ribavirina entre 2001 y 2006 y tuvo el HCV RNA antes y después del tratamiento. El cumplimiento se calcula en intervalos de 12 semanas utilizando recambios de farmacia. La media de interferón y la adherencia de ribavirina disminuyó 2,5 y 4,1 puntos porcentuales por intervalo de 12 semanas, respectivamente. Entre los genotipos 1/4 de los pacientes, EVR aumenta con la mayor adherencia de ribavirina, pero esta asociación era menos fuerte que el interferón. SVR en estos pacientes fue mayor con el aumento de adhesiones interferón y ribavirina durante el primer segundo, y tercero, pero no el cuarto, 12 semanas de intervalo. Entre el HIV/HCV los pacientes, EVR y SVR aumenta con la más alta de interferón y ribavirina la adhesión. El cumplimiento de ambos antivirales disminuido con el tiempo, pero más aún de la ribavirina.

Notes

Acknowledgments

This work was supported by the National Institutes of Health [K01-AI070001 to V. L. R.] and a Department of Veterans Affairs Competitive Pilot Project Fund grant [to V. K. A.]. This material is based upon work supported in part by the Department of Veterans Affairs. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.

Conflict of interest

None

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Vincent Lo ReIII
    • 1
    • 2
    • 3
    Email author
  • Valerie Teal
    • 2
  • A. Russell Localio
    • 2
  • Valerianna K. Amorosa
    • 1
    • 3
  • David E. Kaplan
    • 3
    • 4
  • Robert Gross
    • 1
    • 2
    • 3
  1. 1.Division of Infectious Diseases, Department of MedicinePerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and BiostatisticsPerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  3. 3.Medicine Service, Philadelphia Veterans Affairs Medical CenterPhiladelphiaUSA
  4. 4.Division of Gastroenterology, Department of MedicinePerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA

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