HIV coinfection predicts failure of ledipasvir/sofosbuvir in treatment-naïve noncirrhotic patients with HCV genotype
Autor (es)
Berenguer, Juan; Calleja Panero, José Luis; Montes, María Luisa; Gil, Ángela; Moreno, Ana; Bañares, Rafael; Aldámiz-Echevarría, Teresa; Albillos, Agustín; Téllez, María Jesús; Olveira, Antonio; Domínguez, Lourdes; Fernández, Inmaculada; García-Samaniego, Javier; Polo, Benjamín A.; Álvarez, Beatriz; Ryan, Pablo; Barrio, José; Devesa, María J.; Benítez, Laura; Santos Gil, Ignacio de los; Buey, Luisa García; Sanz, José; Poves, Elvira; Losa, Juan E.; Fernández-Rodríguez, Conrado; Jarrín, Inmaculada; Calvo, María J.; González García, Juan JuliánEntidad
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Editor
Oxford University Press on behalf of Infectious Diseases Society of AmericaFecha de edición
2019-05-01Cita
10.1093/ofid/ofz214
Open Forum Infectious Diseases 6.5 (2019): 1-10
ISSN
2328-8957DOI
10.1093/ofid/ofz214Financiado por
This work was supported by the Spanish AIDS Research Network (RD16/0025/0017), which is included in the Spanish I+D+I Plan and is co-financed by ISCIII-Subdirección General de Evaluacion and European Funding for Regional Development (FEDER), and the Fondo de Investigación de Sanidad en España (FIS)/Instituto de Salud Carlos III (Spanish Health Research Funds; PI17/00657).Proyecto
Gobierno de España. RD16/0025/0017; Gobierno de España. PI17/00657Versión del editor
https://doi.org/0.1093/ofid/ofz214Materias
Antiviral agents/administration & dosage/*therapeutic use; DAA; Hepatitis C, chronic/*complications/*drug therapy; HIV infections/*complications; Sustained virologic response; MedicinaDerechos
© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. Background.Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Resumen
The efficacy of licensed direct-acting antiviral (DAA) regimens is assumed to be the same for hepatitis C virus (HCV)–monoinfected patients (HCV-Mono) and HIV/HCV-coinfected patients (HCV-Co). However, the high sustained viral response (SVR) rates of DAA regimens and the small number of HIV-infected patients included in registration trials have made it difficult to identify predictors of treatment failure, including the presence of HIV. Methods. We compared treatment outcomes for ledipasvir/sofosbuvir (LDV/SOF) against HCV G1 in treatment-naïve HCV-Mono and HCV-Co without cirrhosis in a prospective registry of individuals receiving DAAs for HCV. Results. Up to September 2017, a total of 17 269 patients were registered, and 1358 patients (1055 HCV-Mono/303 HCV-Co) met the inclusion criteria. Significant differences between HCV-Mono and HCV-Co were observed for age, gender, and G1 subtype distribution. Among HCV-Co, 99.0% were receiving antiretroviral therapy. SVR rates for LDV/SOF at 8 weeks did not differ significantly between HCV-Mono and HCV-Co (96.9% vs 94.0%; P = .199). However, the SVR rate for LDV/SOF at 12 weeks was significantly higher for HCV-Mono than HCV-Co (97.2% vs 91.8%; P = .001). A multivariable logistic regression model including age, sex, liver stiffness, G1 subtype, HCV-RNA, HIV, and treatment duration showed the factors associated with treatment failure to be male sex (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.27–4.91; P = .008) and HIV infection (aOR, 2.23; 95% CI, 1.13–4.38; P = .020). Conclusions. The results of this large prospective study analyzing outcomes for LDV/SOF against HCV G1 in treatment-naïve noncirrhotic patients suggest that HIV infection is a predictor of treatment failure in patients with chronic hepatitis C.
Lista de ficheros
Google Scholar:Berenguer, Juan
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Calleja Panero, José Luis
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Montes, María Luisa
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Gil, Ángela
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Moreno, Ana
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Bañares, Rafael
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Aldámiz-Echevarría, Teresa
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Albillos, Agustín
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Téllez, María Jesús
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Olveira, Antonio
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Domínguez, Lourdes
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Fernández, Inmaculada
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García-Samaniego, Javier
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Polo, Benjamín A.
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Álvarez, Beatriz
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Ryan, Pablo
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Barrio, José
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Devesa, María J.
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Benítez, Laura
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Santos Gil, Ignacio de los
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Buey, Luisa García
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Sanz, José
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Poves, Elvira
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Losa, Juan E.
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Fernández-Rodríguez, Conrado
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Jarrín, Inmaculada
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Calvo, María J.
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González García, Juan Julián
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