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Eradication of hepatitis C virus and non-liver-related non-acquired immune deficiency syndrome-related events in human immunodeficiency virus/hepatitis C virus coinfection.
- Source :
-
Hepatology (Baltimore, Md.) [Hepatology] 2017 Aug; Vol. 66 (2), pp. 344-356. Date of Electronic Publication: 2017 Jun 22. - Publication Year :
- 2017
-
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 <superscript>+</superscript> 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).<br />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).<br /> (© 2017 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3350
- Volume :
- 66
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Hepatology (Baltimore, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 28109003
- Full Text :
- https://doi.org/10.1002/hep.29071