Rapid virological response at week 4 predicts response to pegylated interferon plus ribavirin among HIV/HCV-coinfected patients
| Autor: | Juan A. Pineda, Alicia Gutierrez-Valencia, Julián Torre-Cisneros, Mercedes González-Serrano, José A. Mira, Ignacio Santos, José A. Girón-González, Bárbara Valera-Bestard, Ana Arizcorreta-Yarza, Luis F. López-Cortés, Salvador Vergara, Juan Macías |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Time Factors Hepacivirus Hepatitis C virus HIV Infections Interferon alpha-2 medicine.disease_cause Antiviral Agents Polyethylene Glycols Flaviviridae chemistry.chemical_compound Predictive Value of Tests Interferon Pegylated interferon Ribavirin medicine Humans Pharmacology (medical) Sida Pharmacology biology business.industry Interferon-alpha virus diseases Hepatitis C Chronic biology.organism_classification Virology Recombinant Proteins digestive system diseases Treatment Outcome Infectious Diseases chemistry HIV-1 RNA Viral Drug Therapy Combination Female Viral disease business medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 2040-2058 1359-6535 |
| DOI: | 10.1177/135965350701200412 |
| Popis: | Introduction The clinical applicability of early viral kinetics at week 4 in predicting sustained virological response (SVR) of pegylated interferon (peg-IFN) plus ribavirin (RBV) in HIV/HCV-coinfected patients is unclear. Our objective was to determine if rapid virological response (RVR) at week 4 of therapy with peg-IFN and RBV could predict SVR among HIV/HCV-coinfected patients. Methods HIV/HCV-coinfected patients in whom an HCV viral load determination had been carried out at week 4 of therapy were included in the study. The positive predictive value (PPV) and the negative predictive value (NPV) of RVR (undetectable serum HCV RNA at 4 week) for SVR were calculated in the study population. Receiver operating characteristic curves were calculated to determine the best cutoff of HCV RNA decrease to predict treatment failure. Results A total of 101 HIV/HCV-coinfected patients were included. RVR and SVR were observed in 39 (39%) and in 49 (48%) individuals, respectively. Of patients with RVR, 37/39 patients achieved SVR (PPV: 95%), whereas 50/62 individuals without RVR did not show SVR (NPV: 81%). The highest NPV (96%) was reached by using a cutoff level of HCV RNA decrease of 0.6 log10. By applying this cutoff level, treatment could have been discontinued in 25 (25%) patients. Conclusions An undetectable serum HCV RNA determination at week 4 of treatment with peg-IFN plus RBV is a reliable predictor of SVR in HIV/HCV-coinfected patients. In addition, a decrease of HCV RNA less than 0.6 log10 at this point of treatment could identify an appreciable proportion of individuals who will fail to achieve SVR. |
| Databáze: | OpenAIRE |
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