Baseline serum hepatitis C virus (HCV) RNA level and response at week 4 are the best predictors of relapse after treatment with pegylated interferon plus ribavirin in HIV/HCV-coinfected patients
BACKGROUND: Relapse after achieving virologic response to anti-hepatitis C virus (HCV) treatment considerably reduces sustained virologic response rates. It is unclear what the main predictors of relapse in HCV/HIV-coinfected patients are.
PATIENTS AND METHODS: The Pegasys Ribavirina España Coinfección (PRESCO) study evaluated short and extended duration of treatment for chronic hepatitis C using pegylated interferon (peg-IFN)-alpha2a at a dose of 180 microg/wk plus weight-based ribavirin (RBV) at a dose of 1000 to 1200 mg/d in HIV-infected subjects. Patients with HCV-2/3 were treated for 6 or 12 months, and patients with HCV-1/4 were treated for 12 or 18 months.
RESULTS: Of 389 patients included in the trial, end-of-treatment response was achieved by 262 (67.3%): 106 with HCV-1 (55%), 137 with HCV-2/3 (90%), and 19 with HCV-4 (41%). Six patients were lost to follow-up after completing therapy. Of the remaining 256 patients, 62 (24%) relapsed: 33% of HCV-1 patients, 18% of HCV-2/3 patients, and 21% of HCV-4 patients. In multivariate logistic regression analysis, baseline serum HCV RNA level > or =500,000 IU/mL (relative risk [RR] = 4.81, 95% confidence interval [CI]: 1.52 to 15.22; P = 0.008) and lack of rapid virologic response, defined as undetectable HCV RNA level at week 4 (RR = 2.94, 95% CI: 1.22 to 7.09; P = 0.02) were the best independent predictors of HCV relapse. Use of concomitant antiretroviral therapy also predicted relapse (P = 0.04), and a trend toward a higher relapse rate was recognized for HCV genotypes 1 and 4 versus genotypes 2 and 3 (P = 0.08). Extended treatment did not result in a lower incidence of relapse, at least for HCV genotypes 2 and 3.
CONCLUSION: High baseline serum HCV RNA level and lack of undetectable viremia at week 4 are the most significant predictors of relapse in HCV/HIV-coinfected patients treated with peg-IFN plus weight-based RBV.
| Errataetall: | |
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| Medienart: |
Artikel |
| Erscheinungsjahr: |
2007 |
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| Erschienen: |
2007 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
|---|---|
| Enthalten in: |
Journal of acquired immune deficiency syndromes (1999) - 45(2007), 4 vom: 01. Aug., Seite 439-44 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Núñez, Marina [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.08.2007 Date Revised 30.09.2020 published: Print ErratumIn: J Acquir Immune Defic Syndr. 2008 Apr 1;47(4):528 Mariño, Angel [corrected to Mariño, Ana] Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM169984435 |
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| 041 | |a eng | ||
| 100 | 1 | |a Núñez, Marina |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Baseline serum hepatitis C virus (HCV) RNA level and response at week 4 are the best predictors of relapse after treatment with pegylated interferon plus ribavirin in HIV/HCV-coinfected patients |
| 264 | 1 | |c 2007 | |
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| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
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| 500 | |a Date Completed 27.08.2007 | ||
| 500 | |a Date Revised 30.09.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a ErratumIn: J Acquir Immune Defic Syndr. 2008 Apr 1;47(4):528 Mariño, Angel [corrected to Mariño, Ana] | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Relapse after achieving virologic response to anti-hepatitis C virus (HCV) treatment considerably reduces sustained virologic response rates. It is unclear what the main predictors of relapse in HCV/HIV-coinfected patients are | ||
| 520 | |a PATIENTS AND METHODS: The Pegasys Ribavirina España Coinfección (PRESCO) study evaluated short and extended duration of treatment for chronic hepatitis C using pegylated interferon (peg-IFN)-alpha2a at a dose of 180 microg/wk plus weight-based ribavirin (RBV) at a dose of 1000 to 1200 mg/d in HIV-infected subjects. Patients with HCV-2/3 were treated for 6 or 12 months, and patients with HCV-1/4 were treated for 12 or 18 months | ||
| 520 | |a RESULTS: Of 389 patients included in the trial, end-of-treatment response was achieved by 262 (67.3%): 106 with HCV-1 (55%), 137 with HCV-2/3 (90%), and 19 with HCV-4 (41%). Six patients were lost to follow-up after completing therapy. Of the remaining 256 patients, 62 (24%) relapsed: 33% of HCV-1 patients, 18% of HCV-2/3 patients, and 21% of HCV-4 patients. In multivariate logistic regression analysis, baseline serum HCV RNA level > or =500,000 IU/mL (relative risk [RR] = 4.81, 95% confidence interval [CI]: 1.52 to 15.22; P = 0.008) and lack of rapid virologic response, defined as undetectable HCV RNA level at week 4 (RR = 2.94, 95% CI: 1.22 to 7.09; P = 0.02) were the best independent predictors of HCV relapse. Use of concomitant antiretroviral therapy also predicted relapse (P = 0.04), and a trend toward a higher relapse rate was recognized for HCV genotypes 1 and 4 versus genotypes 2 and 3 (P = 0.08). Extended treatment did not result in a lower incidence of relapse, at least for HCV genotypes 2 and 3 | ||
| 520 | |a CONCLUSION: High baseline serum HCV RNA level and lack of undetectable viremia at week 4 are the most significant predictors of relapse in HCV/HIV-coinfected patients treated with peg-IFN plus weight-based RBV | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 650 | 7 | |a Interferon alpha-2 |2 NLM | |
| 650 | 7 | |a Interferon-alpha |2 NLM | |
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| 650 | 7 | |a Polyethylene Glycols |2 NLM | |
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| 700 | 1 | |a Mariño, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Mariño, Angel |e verfasserin |4 aut | |
| 700 | 1 | |a Miralles, Celia |e verfasserin |4 aut | |
| 700 | 1 | |a Berdún, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Sola, Julio |e verfasserin |4 aut | |
| 700 | 1 | |a Hernandez-Burruezo, Juan Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Galindo, Maria Jose |e verfasserin |4 aut | |
| 700 | 1 | |a Barreiro, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Martin-Carbonero, Luz |e verfasserin |4 aut | |
| 700 | 1 | |a Soriano, Vincent |e verfasserin |4 aut | |
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