Efficacy of pegylated interferon plus ribavirin treatment in HIV ...

Journal of Antimicrobial Chemotherapy (2008) 62, 1365 –1373 doi:10.1093/jac/dkn420 Advance Access publication 13 October 2008

Efficacy of pegylated interferon plus ribavirin treatment in HIV/hepatitis C virus co-infected patients receiving abacavir plus lamivudine or tenofovir plus either lamivudine or emtricitabine as nucleoside analogue backbone Jose´ A. Mira1,2†, Luis F. Lo´pez-Corte´s3†, Pablo Barreiro4, Cristina Tural5, Manuel Torres-Tortosa6†, Ignacio de los Santos Gil7, Patricia Martı´n-Rico8†, Marı´a J. Rı´os-Villegas9†, ´ ngel Lo´pez-Ruz12†, Jose´ Juan Herna´ndez-Burruezo10†, Dolores Merino11†, Miguel A Antonio Rivero13†, Leopoldo Mun˜oz14†, Mercedes Gonza´lez-Serrano15†, Antonio Collado16†, Juan Macı´as1,2†, Pompeyo Viciana3†, Vincent Soriano4 and Juan A. Pineda1*† 1

Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, Spain; 2Servicio de Medicina Interna, Hospital Universitario de Valme, Sevilla, Spain; 3Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocı´o, Sevilla, Spain; 4Servicio de Enfermedades Infecciosas, Hospital Carlos III, Madrid, Spain; 5Unidad Clı´nica de VIH, Servicio de Medicina Interna, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain; 6Seccio´n de Enfermedades Infecciosas, Hospital Punta Europa, Algeciras, Spain; 7 Servicio de Medicina Interna-Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain; 8Servicio de Enfermedades Infecciosas, Hospital Universitario Carlos Haya, Ma´laga, Spain; 9Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain; 10Unidad de Enfermedades Infecciosas, Complejo Hospitalario de Jae´n, Jae´n, Spain; 11Servicio de Medicina Interna, Hospital Juan Ramo´n Jime´nez, Huelva, Spain; 12Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, Granada, Spain; 13Seccio´n de Enfermedades Infecciosas, Hospital Universitario Reina Sofı´a, Co´rdoba, Spain; 14Unidad de Enfermedades Infecciosas, Hospital Clı´nico Universitario San Cecilio, Granada, Spain; 15Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Ma´laga, Spain; 16Servicio de Medicina Interna, Hospital Torreca´rdenas, Almerı´a, Spain Received 15 March 2008; returned 23 April 2008; revised 7 September 2008; accepted 14 September 2008 Objectives: To compare the response to hepatitis C virus (HCV) therapy among human immunodeficiency virus (HIV)/HCV co-infected patients receiving a nucleos(t)ide reverse transcriptase inhibitor [N(t)RTI] backbone consisting of abacavir plus lamivudine with that observed in subjects who receive tenofovir plus lamivudine or emtricitabine. Methods: A total of 256 subjects, enrolled in a cohort of 948 HIV-infected patients who received pegylated interferon and ribavirin from October 2001 to January 2006, were included in this study. All patients were taking one protease inhibitor or one non-nucleoside reverse transcriptase inhibitor and abacavir plus lamivudine or tenofovir plus lamivudine or emtricitabine as N(t)RTI backbone during HCV therapy. Sustained virological response (SVR) rates in both backbone groups were compared. Results: In an intention-to-treat analysis, 20 out of 70 (29%) individuals under abacavir and 83 out of 186 (45%) under tenofovir showed SVR (P 5 0.02). N(t)RTI backbone containing tenofovir was an independent predictor of SVR in the multivariate analysis [adjusted odds ratio (95% CI), 2.6 (1.05–6.9); P 5 0.03]. The association between abacavir use and lower SVR was chiefly seen in patients with plasma HCV-RNA load higher than 600 000 IU/mL and genotype 1 or 4. Among patients treated with .....................................................................................................................................................................................................................................................................................................................................................................................................................................

*Corresponding author. Tel: þ34-955015864; Fax: þ34-955015787; E-mail: [email protected] †Grupo HEPAVIR de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI) .....................................................................................................................................................................................................................................................................................................................................................................................................................................

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