1. Virological response rates for telaprevir-based hepatitis C triple therapy in patients with and without HIV coinfection.
- Author
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Martel ‐ Laferrière, V, Brinkley, S, Bichoupan, K, Posner, S, Stivala, A, Perumalswami, P, Schiano, TD, Sulkowski, M, Dieterich, DT, and Branch, AD
- Subjects
COMBINATION drug therapy ,CHI-squared test ,CONFIDENCE intervals ,EPIDEMIOLOGY ,FISHER exact test ,HEPATITIS C ,HIV infections ,INTERFERONS ,RESEARCH funding ,RIBAVIRIN ,T-test (Statistics) ,U-statistics ,COMORBIDITY ,LOGISTIC regression analysis ,DATA analysis ,DATA analysis software ,DESCRIPTIVE statistics ,TELAPREVIR - Abstract
Objectives Pegylated-interferon/ribavirin dual therapy for hepatitis C virus ( HCV) infection has a lower sustained virological response ( SVR) rate in HIV/ HCV-coinfected patients than in HCV monoinfected patients, but little is known about the relative effectiveness of teleprevir-based triple therapy in the two groups. Methods Data on 33 coinfected and 116 monoinfected patients were analysed on an intention-to-treat basis. SVR12 was defined as undetectable HCV RNA at week 12 post-end-of-treatment, severe anaemia as haemoglobin ≤ 89 g/L or a drop of ≥ 45 g/L, and advanced fibrosis/cirrhosis as Fib-4 ≥ 3.25. All coinfected patients had well controlled HIV infection. Results The groups were similar in age, gender, percentage with Fib-4 ≥ 3.25 and HCV viral load, but differed in previous treatment response, with more coinfected patients being nonresponders or treatment-intolerant (75.8% vs. 50.0% for monoinfected patients; P < 0.01). During treatment, the percentages of patients with undetectable HCV RNA were similar, but, surprisingly, this percentage tended to be higher in coinfected patients. SVR12 rates were 60.6% in coinfected patients vs. 42.2% in monoinfected patients ( P = 0.06). In multivariable analysis, SVR12 was associated with HIV infection [odds ratio ( OR) 3.55; P < 0.01], African American race ( OR 0.37; P = 0.03) and previous treatment response ( OR 0.46; P = 0.03). Rates of severe anaemia (45.5 vs. 58.6% in coinfected and monoinfected patients, respectively; P = 0.18) were similar in the two groups, but rash (15.2 vs. 34.5%, respectively; P = 0.03) and rectal symptoms (12.1 vs. 43.1%, respectively; P < 0.01) were less common in coinfected patients. Conclusions Virological responses of coinfected and monoinfected patients did not differ significantly, but tended to be higher in coinfected patients, who had a 60.6% SVR12 rate. Telaprevir-based triple therapy is a promising option for coinfected patients with well-controlled HIV infection. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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