Publication:
Pegylated interferon plus ribavirin in HIV-infected patients with recurrent hepatitis C after liver transplantation: A prospective cohort study (vol 62, pg 92, 2015)

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Date

2016-03-01

Authors

Castells, Lluis
Rimola, Antoni
Manzardo, Christian
Valdivieso, Andres
Luis Montero, Jose
Barcena, Rafael
Abradelo, Manuel
Xiol, Xavier
Aguilera, Victoria
Salcedo, Magdalena

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Elsevier
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Background & aims: The aim of this study was to evaluate the results of treatment with pegylated interferon and ribavirin for the recurrence of hepatitis C after liver transplantation in HCV/HIV-coinfected patients. Methods: This was a prospective, multicentre cohort study, including 78 HCV/HIV-coinfected liver transplant patients who received treatment for recurrent hepatitis C. For comparison, we included 176 matched HCV-monoinfected patients who underwent liver transplantation during the same period of time at the same centres and were treated for recurrent hepatitis C. Results: Antiviral therapy was discontinued prematurely in 56% and 39% (p = 0.016), mainly because of toxicity (22% and 11%, respectively; p=0.034). Sustained virological response (SVR) was achieved in 21% of the coinfected patients and in 36% of monoinfected patients (p = 0.013). For genotype 1, SVR rates were 10% and 33% (p = 0.002), respectively; no significant differences were observed for the other genotypes. A multivariate analysis based on the whole series identified HIV-coinfection as an independent predictor of lack of SVR (OR, 0.17; 95% CI, 0.06-0.42). Other predictors of SVR were donor age, pretreatment HCV viral load, HCV genotype, and early virological response. SVR was associated with a significant improvement in survival: 5-year survival after antiviral treatment was 79% for HCV/HIV-coinfected patients with SVR vs. 43% for those without (p = 0.02) and 92% vs. 60% in HCV-monoinfected patients (p < 0.001), respectively. Conclusions: The response to pegylated interferon and ribavirin was poorer in HCV/HIV-coinfected liver recipients, particularly those with genotype 1. However, when SVR was achieved, survival of coinfected patients increased significantly.

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MeSH Terms

Antiviral Agents
Coinfection
Drug Carriers
Drug Therapy, Combination
Liver Transplantation
RNA, Viral
Recombinant Proteins

DeCS Terms

ARN viral
Antivirales
Coinfección
Portadores de fármacos
Proteínas recombinantes
Quimioterapia combinada
Trasplante de hígado

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Keywords

Antiviral treatment, HCV infection, HIV infection, Liver transplantation, Pegylated-interferon, Recurrence of hepatitis C, Ribavirin; Survival

Citation

Castells L, Rimola A, Manzardo C, Valdivieso A, Montero JL, Barcena R, et al. Pegylated interferon plus ribavirin in HIV-infected patients with recurrent hepatitis C after liver transplantation: a prospective cohort study. J Hepatol. 2015 Jan;62(1):92-100