Eradication of Hepatitis C Virus and Non-Liver-Related Non-Acquired Immune Deficiency Syndrome-Related Events in Human Immunodeficiency Virus/Hepatitis C Virus Coinfection
Por:
Berenguer, J, Rodriguez-Castellano, E, Carrero, A, Von Wichmann, MA, Montero, M, Galindo, MJ, Mallolas, J, Crespo, M, Ellez, MJT, Quereda, C, Sanz, J, Barros, C, Tural, C, Santos, I, Pulido, F, Guardiola, JM, Rubio, R, Ortega, E, Montes, ML, Jusdado, JJ, Gaspar, G, Esteban, H, Bellon, JEM, Gonzalez-Garcia, J
Publicada:
1 ago 2017
Resumen:
We assessed non-liver-related non-acquired immunodeficiency syndrome (AIDS)-related (NLR-NAR) events and mortality in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with interferon (IFN) and ribavirin (RBV), between 2000 and 2008. The censoring date was May 31, 2014. Cox regression analysis was performed to assess the adjusted hazard rate (HR) of overall death in responders and nonresponders. Fine and Gray regression analysis was conducted to determine the adjusted subhazard rate (sHR) of NLR deaths and NLR-NAR events considering death as the competing risk. The NLR-NAR events analyzed included diabetes mellitus, chronic renal failure, cardiovascular events, NLR-NAR cancer, bone events, and non-AIDS-related infections. The variables for adjustment were age, sex, past AIDS, HIV transmission category, nadir CD41 T-cell count, antiretroviral therapy, HIV RNA, liver fibrosis, HCV genotype, and exposure to specific anti-HIV drugs. Of the 1,625 patients included, 592 (36%) had a sustained viral response (SVR). After a median 5-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR, 0.57; 95% confidence interval [CI], 0.35-0.93; P=0.024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR, 0.43; 95% CI, 0.17-1.09; P=0.075). Conclusion: Our data suggest that eradication of HCV in coinfected patients is associated not only with a reduction in the frequency of death, HIV progression, and liver-related events, but also with a reduced hazard of diabetes mellitus and possibly of chronic renal failure. These findings argue for the prescription of HCV therapy in coinfected patients regardless of fibrosis stage.
Filiaciones:
Berenguer, J:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
IISGM, Madrid, Spain
Rodriguez-Castellano, E:
Hosp Univ La Paz, Madrid, Spain
Carrero, A:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
IISGM, Madrid, Spain
Von Wichmann, MA:
Hosp Donostia, San Sebastian, Spain
Montero, M:
Hosp Univ La Fe, Valencia, Spain
Galindo, MJ:
Hosp Clin Univ, Valencia, Spain
Mallolas, J:
Hosp Clin Barcelona, Barcelona, Spain
Crespo, M:
Univ Vigo, Complexo Hosp, Vigo, Spain
Ellez, MJT:
Hosp Clin San Carlos, Madrid, Spain
Quereda, C:
Hosp Univ Ramon & Cajal, Madrid, Spain
Sanz, J:
Hosp Univ Principe Asturias, Alcal Henares, Spain
Barros, C:
Hosp Univ Mostoles, Mostoles, Spain
Tural, C:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Santos, I:
Hosp Univ La Princesa, Madrid, Spain
Pulido, F:
Hosp Univ 12 Octubre Imas12, Madrid, Spain
Guardiola, JM:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Rubio, R:
Hosp Univ 12 Octubre Imas12, Madrid, Spain
Ortega, E:
Hosp Gen Univ, Valencia, Spain
Montes, ML:
Hosp Univ La Paz, Madrid, Spain
Jusdado, JJ:
Hosp Univ Severo Ochoa, Leganes, Spain
Gaspar, G:
Hosp Univ Getafe, Getafe, Spain
Esteban, H:
Fdn SEIMC GESIDA, Madrid, Spain
Bellon, JEM:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
IISGM, Madrid, Spain
Gonzalez-Garcia, J:
Hosp Univ La Paz, Madrid, Spain
hybrid, Green Published
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