- Poster presentation
- Open access
- Published:
Rapid virological response is the best predictor for achieving SVR under peg-IFN/ribavirin hepatitis C therapy in HIV/HCV co-infected patients
Journal of the International AIDS Society volume 11, Article number: P266 (2008)
Background
Within the Köln/Bonn cohort, all IFN/RBV-treated HIV/HCV co-infected patients were evaluated for treatment outcome and possible predictive factors for achieving cure of HCV infection defined as undetectable HCV-RNA 24 weeks upon completion of HCV therapy (SVR).
Methods
Patients included in this retrospective multicentre cohort study received peg-IFN (1.5 μg/kg body weight or 180 μg, respectively) once weekly and weight-based RBV (600–1200 mg) once daily. Patients with HCV-genotypes 2 or 3 were treated for 24 or 48 weeks; patients with genotype 1 or 4 received 48 weeks of therapy. Primary end-point was SVR. Binary logistic regression and calculation of positive predictive values (PPV) were used to identify prognostic parameters for achieving SVR and EVR (early virological response defined as undetectable HCV-RNA after 12 weeks of IFN/RBV treatment), respectively.
Summary of results
A total of 227 HIV/HCV co-infected patients were included. Patients were predominantly male (73%), mean age was 41 years, 59,5% received HAART. The distribution of HCV-genotypes (GT) was as follows: GT 1: 56%, GT 2: 6%, GT 3: 31%, GT 4: 7%. Further baseline characteristics (median) were: CD4-count 531/μL (26%), HIV-RNA 11.635 cps/mL, HCV-RNA 2.444.870 IU/mL, ALT 69 U/L, Hb 14.4 g/dL, leucocytes 5810/μL, platelets 190/nL. SVR was achieved by 41% (GT 1/4: 32%; GT 2/3: 59%) of all patients. HCV-GT 2 or 3 (p < 0.001, 95% confidence interval [CI] 2.19 to 8.02; PPV 67.82%), rapid virological response (RVR, defined as undetectable serum-RNA at week 4) (p < 0.001, CI 5.42 to 44.36; PPV 83.78%) and EVR (p < 0.001, CI 6.71 to 26.01; PPV 71.56%) were the best independent predictors for achieving SVR. Positive predictives for EVR were HCV-GT 2 or 3 (p < 0.001, CI 2.81 to 10.55; PPV 78.68%), RVR (p < 0.001, CI 3.36 to 24.24; PPV 87.23%) and the lack of HAART (p = 0.043, CI 0.28 to 0.98; PPV 64.82%).
Conclusion
The most reliable predictive factor for achieving sustained virological response in HIV/HCV co-infected patients treated with peg-IFN plus RBV is to obtain rapid virological response. Further positive predictives for obtaining SVR are infection with HCV-GT 2 or 3 and early virological response (EVR). Positive predictive factors for obtaining EVR are again HCV infection with GT 2 or 3, RVR and, interestingly, also stable HIV infection without a need for HAART therapy.
Author information
Authors and Affiliations
Rights and permissions
Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License ( https://creativecommons.org/licenses/by-nc/2.0 ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
About this article
Cite this article
Janke, M., Luechters, G., Vogel, M. et al. Rapid virological response is the best predictor for achieving SVR under peg-IFN/ribavirin hepatitis C therapy in HIV/HCV co-infected patients. JIAS 11 (Suppl 1), P266 (2008). https://doi.org/10.1186/1758-2652-11-S1-P266
Published:
DOI: https://doi.org/10.1186/1758-2652-11-S1-P266