Re-treatment of chronic HCV infection in HIV co-infected patients and predictors of sustained viral response - 06/04/14
, Firouzé Bani-Sadr a, c, ⁎ , Delphine Fromentin a , Cécile Goujard e , Mojgan Hessamfar f , Yazdan Yazdanpanah g , Stanislas Pol h , Patrice Cacoub i , Christian Perronne j , Fabrice Carrat a, b Summary |
Background |
In HIV–HCV co-infected patients who failed to achieve sustained viral response (SVR) with PEG-IFN + RBV, data on SVR rate after re-treatment with Peginterferon (PEG-IFN) + ribavirin (RBV) are scarce.
Aim |
The aim of this study was to identify factors predictive of SVR after re-treatment in a large cohort of HIV/HCV co-infected patients – the ANRS-CO7 Ribavic cohort study, which is a long term follow-up study of patients who were included in the randomized controlled trial ANRS-HC02 RIBAVIC.
Results |
Among the 176 patients who did not achieve a SVR during the RIBAVIC trial, sixty-six patients (38%) experienced a re-treatment with PEG-IFN + RBV. The SVR observed to the second course of HCV treatment was 44% overall, i.e. 93% in patients who were relapsers and 29% in nonresponders. In the nonresponders subgroup, the SVR rate was 42% in patients with genotype 2–3 and 26% in patients with genotype 1–4. In multivariate analysis, age ≤40 years (OR 12.4 95% CI 1.9–171, p = 0.003), genotype 2–3 versus 1–4 (OR 8.1 95% CI 8.1 1.2–97, p = 0.002) and relapser status at first treatment (OR 32.9 95% CI 3.2–278, p < 0.0001) were significantly associated with SVR.
Conclusion |
Our findings strongly suggest that patients who relapse after first treatment, particularly those infected with HCV genotype 2–3, or living in countries with no access to the direct acting antiviral drugs for HCV, could be successfully re-treated with standard bi-therapy of PEG-IFN + RBV regimen.
Le texte complet de cet article est disponible en PDF.Keywords : HIV/HCV coinfection, HCV sustained viral response, HCV relapsers, HCV re-treatment, Peginterferon alfa plus ribavirin
Plan
Vol 68 - N° 5
P. 462-466 - mai 2014 Retour au numéro
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