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Ann Hepatol ; 14(4): 464-9, 2015.
Article de Anglais | MEDLINE | ID: mdl-26019032

RÉSUMÉ

UNLABELLED: BACKGROUND AND RATIONALE FOR THE STUDY: We assessed the association of CD4+ T-cell counts and HIV-RNA on sustained viral response (SVR) after therapy with pegylated interferon and ribavirin (PR) in HIV/HCV coinfected patients. We examined two large cohorts of coinfected patients treated with PR in Spain between 2000 and 2008. SVR was defined as undetectable HCV-RNA at 24 weeks after the end of PR. RESULTS: We studied 1682 patients, of whom 38% achieved SVR. Baseline factors independently associated with reduced odds of SVR included genotype 1 or 4, HCV-RNA > 500,000 IU/mL, advanced liver fibrosis, CDC clinical category C, and detectable HIV-RNA. By multivariate logistic regression analysis, we found that, in comparison with patients with combination antiretroviral therapy (cART) and undetectable HIV-RNA, the odds ratio [95% confidence interval (CI)] of SVR was 0.56 (0.41-0.78) for cART and detectable HIV-RNA, 0.86 (0.56-2.57) for no-cART and detectable HIV-RNA, and 1.38 (0.74-2.57) for no-cART and undetectable HIV-RNA. CONCLUSIONS: Detectable HIV-RNA, but not CD4+ T-cell count, was associated with reduced odds of SVR. However, this finding was only confirmed for cART and detectable HIV-RNA, raising the question as whether this represents a true association of HIV-RNA on response to PR or a spurious association due to poor adherence to treatment.


Sujet(s)
Antiviraux/usage thérapeutique , Co-infection , Infections à VIH/diagnostic , VIH (Virus de l'Immunodéficience Humaine)/génétique , Hepacivirus/effets des médicaments et des substances chimiques , Hépatite C/traitement médicamenteux , Interférons/usage thérapeutique , ARN viral/génétique , Ribavirine/usage thérapeutique , Adulte , Agents antiVIH/usage thérapeutique , Antiviraux/effets indésirables , Numération des lymphocytes CD4 , Femelle , Génotype , VIH (Virus de l'Immunodéficience Humaine)/effets des médicaments et des substances chimiques , Infections à VIH/sang , Infections à VIH/traitement médicamenteux , Infections à VIH/immunologie , Infections à VIH/virologie , Hepacivirus/génétique , Hépatite C/sang , Hépatite C/diagnostic , Humains , Interférons/effets indésirables , Modèles logistiques , Mâle , Analyse multifactorielle , Odds ratio , Valeur prédictive des tests , ARN viral/sang , Études rétrospectives , Ribavirine/effets indésirables , Facteurs de risque , Espagne , Facteurs temps , Résultat thérapeutique , Charge virale
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