AI Article Synopsis
- The study aimed to evaluate how effective pegylated interferon (peg-IFN) plus ribavirin (RBV) is in HIV patients with liver cirrhosis caused by hepatitis C virus (HCV) and identify factors influencing treatment success.
- In a cohort of 629 HIV/HCV-coinfected patients, only 25% of those with cirrhosis achieved sustained virologic response (SVR) compared to 39% of patients without cirrhosis, suggesting treatment is less effective in cirrhotic patients.
- Among those with cirrhosis, treatment success varied significantly by HCV genotype, with the highest SVR observed in genotype 3, while side effects led to more treatment discontinu
Article Abstract
Background: The objective of this study was to determine the efficacy of pegylated interferon (peg-IFN) plus ribavirin (RBV) in human immunodeficiency virus (HIV)-infected patients with hepatitis C virus (HCV)-related compensated liver cirrhosis, as well as the predictors of response in these individuals.
Methods: All subjects enrolled in a prospective cohort of 841 HIV/HCV-coinfected patients who received peg-IFN and RBV and who had a liver biopsy or a liver stiffness measurement within the year before starting peg-IFN plus RBV were included in this study. The sustained virologic response (SVR) rate and predictors of SVR response were analyzed.
Results: A total of 629 patients were included in this study; 175 (28%) had cirrhosis. In an intention-to-treat analysis, 44 (25%) patients with cirrhosis and 177 (39%) without cirrhosis achieved SVR (P = .001). Among patients with cirrhosis, SVR was observed in 14%, 47%, and 30% of individuals with HCV genotypes 1, 2-3, and 4, respectively. Discontinuation of therapy owing to adverse events was observed in 30 (17%) individuals with cirrhosis and 37 (8%) subjects without cirrhosis (P = .001).
Conclusions: The efficacy of peg-IFN plus RBV among HIV/HCV-coinfected patients with cirrhosis is lower than in those without cirrhosis, although this antiviral combination still leads to a substantial rate of SVR in those carrying HCV genotype 3. A higher rate of discontinuations of HCV therapy due to adverse events among cirrhotic patients could partially explain the differences in the SVR rate between both populations.
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