Among patients with HIV and hepatitis C coinfection,
data indicate that the eradication of hepatitis C was associated with a
reduction in HIV progression and mortality at 5 years follow-up.
As HCV infection has been found to hasten HIV
progression and mortality, we aimed to determine the effect of achieving a
sustained virological response after interferon plus ribavirin therapy on HIV
progression and mortality not related to liver disease in HIV/HCV-coinfected
patients, the study researchers wrote.
The cohort included 1,599 patients (39% had a sustained
virological response) with HIV/HCV coinfection who were administered treatment
with interferon plus ribavirin between 2000 and 2008.
A significantly higher frequency and rate for liver
decompensation, liver transplantation and hepatocellular carcinoma was
identified among the non-responder group at 56.9 months follow-up.
Compared with responders, non-responders also had a
higher rate for new AIDS-defining conditions (P=.003); mortality
associated with the liver as well as non-liverrelated deaths; and
non-liverrelated, non-AIDSrelated deaths.
The median age of the study participants was 40 years;
75% were male; and 23% had a previous AIDS-defining condition.
The researchers reported several study limitations: the
study is not entirely prospective; there was a lack of information about ART
adherence during follow-up; and the lack of data on pneumococcal vaccinations
and baseline comorbidities such as diabetes, smoking and cardiovascular risk
These findings support an increasingly strong
rational for earlier evaluation of new direct-acting antivirals against HCV in
coinfected patients, a subgroup with a hugely unmet need for treatment,
the researchers wrote.
Berenguer J. Clin Infect Dis. 2012;doi:10.1093/cid/cis500.
The researchers report no relevant financial