Therapeutical Aspects and Outcome of HIV/HCV Coinfected Patients Treated with Pegylated Interferon plus Ribavirin in an Italian Cohort

Righi, Elda; Beltrame, Andrea; Bassetti, Matteo; Lindström, Vesa; Mazzarello, Giovanni; Dentone, Chiara; Biagio, Antonio Di; Ratto, S; Viscoli, Claudio

doi:10.1007/s15010-008-7319-5

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…The double infection is rather frequent, due to common routes of transmission [2,35-37], and liver disease is the second leading cause of death in patients infected by HIV [38]. …”

Section: Discussionmentioning

confidence: 99%

HCV core antigen and HCV-RNA in HIV/HCV co-infected patients with different HCV genotypes

Garbuglia

Monachetti

Galli³

et al. 2014

BMC Infect Dis

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BackgroundA good correlation between HCV core antigen (HCVAg) and different HCV-RNA assays has been described, but little data are available in HCV/HIV co-infection. We aimed to evaluate HCVAg in comparison with HCV-RNA and to determine their kinetics during antiviral treatment in selected HCV/HIV co-infected patients.Methods355 samples from 286 HCV/HIV co-infected subjects for whom HCV-RNA (Abbott RealTime) was requested were analysed also for HCVAg (Abbott ARCHITECT) in order to evaluate the correlation between the two parameters both in patients treated or untreated for chronic hepatitis C and according to different HCV genotypes. The differences between percentages were evaluated by chi square or Fisher’s exact test, while mean and median values were compared by Student’s t test or the Mann–Whitney test, respectively. All differences were considered significant for a p value <0.05.ResultsHCVAg was detectable on 288/315 sera (91.4%) positive for HCV-RNA and in 5 out of40 (12.5%) sera with undetectable HCV-RNA for a total concordance of 90.1%. The correlation was fair both in untreated (r = 0.742) and in treated (r = 0.881) patients and stronger for genotypes 1 and 4 than for genotype 3. Both HCV-RNA and HCVAg levels were significantly higher (p = 0.028 and p = 0.0098, respectively) in patients infected by genotype 1 than by genotype 3. The mean ratio of Log values between HCV-RNA (IU/mL) and HCVAg (fmol/liter) was 2.27 ± 1.09 in untreated and 2.20 ± 0.82 in treated patients (p = n.s.),consistent with a sensitivity of HCVAg corresponding to about 1,000 IU/mL of HCV-RNA, and ranged from 2.21 to 2.32 among HCV genotypes with no significant differences; five samples (1.4%; 2 genotype 1a or 1c, 3 genotype 3a) showed highly divergent values. The analysis of 18 monitoring profiles from patients treated with PEG-IFN and Ribavirin showed similar trends, except in one case in which relapse could be predicted by HCVAg and not by HCV-RNA.ConclusionThese results suggest that HCVAg represents an adequate tool for determining an ongoing HCV infection also in HIV co-infected patients, with lower costs and faster turnaround time than HCV-RNA.

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“…The double infection is rather frequent, due to common routes of transmission [2,35-37], and liver disease is the second leading cause of death in patients infected by HIV [38]. …”

Section: Discussionmentioning

confidence: 99%

HCV core antigen and HCV-RNA in HIV/HCV co-infected patients with different HCV genotypes

Garbuglia

Monachetti

Galli³

et al. 2014

BMC Infect Dis

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“…In HIV/HCV co-infected patients, results obtained with PEG-IFN + ribavirin (RBV) [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] were superior to those with PEG-IFN alone, standard IFN alone [48] , or standard IFN + RBV (Table 2). A meta-analyses of 6 randomized controlled studies showed superior sustained virologic response (SVR) with PEG-IFN + RBV compared with IFN + RBV and PEG-IFN monotherapy.…”

Section: Therapeutic Regimen For Treating Hcvmentioning

confidence: 99%

“…Pérez-Olmeda et al [39] Cargnel et al [40] ( Laguno et al [42] ( Myers et al [43] ( Chung et al [44] ( Moreno et al [45] ( Torriani et al [46] ( [49] Moreno et al [50] ( Voigt et al [52] ( Fuster et al [53] ( Righi et al [54] ( Responses are on intent to treat analysis. ETR: End of treatment response (HCVRNA < 50 copies/mL); SVR: Sustained virologic response (HCVRNA < 50 copies/mL 6 mo after discontinuing treatment); PEG-IFN: Pegylated interferon; RBV-ribavirin; GT: Genotype; tiw: Three times a week; ACTG: AIDS clinical trial group; APRICOT: AIDS pegasys ribavirin international coinfection trial.…”

Section: Etr Svr Etr Svr Etr Svrmentioning

confidence: 99%

Management of hepatitis C virus infection in HIV/HCV co-infected patients: Clinical review

Singal¹,

Anand²

2009

WJG

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N e a r l y o n e fo u r t h o f i n d i v i d u a l s w i t h h u m a n immunodeficiency virus (HIV) infection have hepatitis C virus (HCV) infection in the US and Western Europe. With the availability of highly active antiretroviral therapy and the consequent reduction in opportunistic infections, resulting in the prolongation of the life span of HIV-infected patients, HCV co-infection has emerged as a significant factor influencing the survival of HIV patients. Patients with HIV/HCV co-infection have a faster rate of fibrosis progression resulting in more frequent occurrences of cirrhosis, end-stage liver disease, and hepatocellular carcinoma. However, the mechanism of interaction between the two viruses is not completely understood. The treatment for HCV in co-infected patients is similar to that of HCV monoinfection; i.e., a combination of pegylated interferon and ribavirin. The presence of any barriers to anti-HCV therapy should be identified and eliminated in order to recruit all eligible patients. The response to treatment in co-infected patients is inferior compared to the response in patients with HCV mono-infection. The sustained virologic response rate is only 38% for genotype-1 and 75% for genotype-2 and -3 infections. Liver transplantation is no longer considered a contraindication for end-stage liver disease in coinfected patients. However, the 5 year survival rate is lower in co-infected patients compared to patients with HCV mono-infection (33% vs 72%, P = 0.07). A better understanding of liver disease in co-infected patients is needed to derive new strategies for improving outcome and survival.

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“…A particularly encouraging result was that the pegylated interferon and ribavirin combination achieved an SVR in 27-44% of coinfected patients [8][9][10][11], resulting in histopathological improvement in most of them. Recent results report similar SVR rates in coinfected more than in HCV mono-infected patients [12][13][14][15]. HCV treatment, however, is given to a small number of HIV-HCV coinfected patients for many reasons, e.g., HCV treatment deemed questionable (minimal hepatic lesions, alcohol abuse, active drug use), lack of available liver biopsy, psychiatric contraindication, and physicians' conviction of poor patient compliance [16][17][18][19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Care of hepatitis C virus infection in human immunodeficiency virus-infected patients: Modifications in three consecutive large surveys between 2004 and 2009

Cacoub

Halfon

Rosenthal

et al. 2010

Journal of Hepatology

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Therapeutical Aspects and Outcome of HIV/HCV Coinfected Patients Treated with Pegylated Interferon plus Ribavirin in an Italian Cohort

Cited by 10 publications

References 22 publications

HCV core antigen and HCV-RNA in HIV/HCV co-infected patients with different HCV genotypes

HCV core antigen and HCV-RNA in HIV/HCV co-infected patients with different HCV genotypes

Management of hepatitis C virus infection in HIV/HCV co-infected patients: Clinical review

Care of hepatitis C virus infection in human immunodeficiency virus-infected patients: Modifications in three consecutive large surveys between 2004 and 2009

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