1. Eradication of hepatitis C virus and non-liver-related non-acquired immune deficiency syndrome-related events in human immunodeficiency virus/hepatitis C virus coinfection.
- Author
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Berenguer J, Rodríguez-Castellano E, Carrero A, Von Wichmann MA, Montero M, Galindo MJ, Mallolas J, Crespo M, Téllez MJ, Quereda C, Sanz J, Barros C, Tural C, Santos I, Pulido F, Guardiola JM, Rubio R, Ortega E, Montes ML, Jusdado JJ, Gaspar G, Esteban H, Bellón JM, and González-García J
- Subjects
- Acquired Immunodeficiency Syndrome diagnosis, Acquired Immunodeficiency Syndrome epidemiology, Adult, Cohort Studies, Coinfection physiopathology, Comorbidity, Databases, Factual, Drug Therapy, Combination, Female, Follow-Up Studies, HIV drug effects, HIV isolation & purification, Hepacivirus drug effects, Hepacivirus isolation & purification, Hepatitis C, Chronic diagnosis, Hepatitis C, Chronic drug therapy, Humans, Incidence, Male, Middle Aged, Regression Analysis, Retrospective Studies, Risk Assessment, Spain epidemiology, Survival Analysis, Time Factors, Treatment Outcome, Acquired Immunodeficiency Syndrome drug therapy, Coinfection drug therapy, Hepatitis C, Chronic epidemiology, Interferon-alpha therapeutic use, Ribavirin therapeutic use
- Abstract
We assessed non-liver-related non-acquired immunodeficiency syndrome (AIDS)-related (NLR-NAR) events and mortality in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with interferon (IFN) and ribavirin (RBV), between 2000 and 2008. The censoring date was May 31, 2014. Cox regression analysis was performed to assess the adjusted hazard rate (HR) of overall death in responders and nonresponders. Fine and Gray regression analysis was conducted to determine the adjusted subhazard rate (sHR) of NLR deaths and NLR-NAR events considering death as the competing risk. The NLR-NAR events analyzed included diabetes mellitus, chronic renal failure, cardiovascular events, NLR-NAR cancer, bone events, and non-AIDS-related infections. The variables for adjustment were age, sex, past AIDS, HIV transmission category, nadir CD4
+ T-cell count, antiretroviral therapy, HIV RNA, liver fibrosis, HCV genotype, and exposure to specific anti-HIV drugs. Of the 1,625 patients included, 592 (36%) had a sustained viral response (SVR). After a median 5-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR, 0.57; 95% confidence interval [CI], 0.35-0.93; P = 0.024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR, 0.43; 95% CI, 0.17-1.09; P = 0.075)., Conclusion: Our data suggest that eradication of HCV in coinfected patients is associated not only with a reduction in the frequency of death, HIV progression, and liver-related events, but also with a reduced hazard of diabetes mellitus and possibly of chronic renal failure. These findings argue for the prescription of HCV therapy in coinfected patients regardless of fibrosis stage. (Hepatology 2017;66:344-356)., (© 2017 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases.)- Published
- 2017
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