Unidad de Enfermedades Infecciosas, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia, Córdoba, Spain.
Infection. 2013 Feb;41(1):21-6. doi: 10.1007/s15010-012-0352-4. Epub 2012 Oct 14.
Hepatitis C virus (HCV) viral relapse (VR) after end-of-treatment response (ETR) in human immunodeficiency virus (HIV) co-infected patients is observed in as many as one in three co-infected patients. The aim of the study was to identify baseline risk factors for VR in HIV/HCV co-infected patients treated with pegylated interferon plus ribavirin (PEG-INF/RBV).
A total of 212 Caucasian HIV-infected patients with chronic hepatitis C naïve for PEG-INF/RBV were followed prospectively. Patients were included in this prospective study if they had completed a full course of therapy with an ETR. We assessed the relationship between VR rate and potential predictors of relapse.
Of the patients followed, 130 (61.3 %) attained ETR and 103 (79.2 %) achieved sustained virological response (SVR). Consequently, 27 (20.8 %) showed VR. Patients who relapsed were more often male (p = 0.036), carried the non-CC rs14158 genotype in the low-density lipoprotein receptor (LDLr) gene (p = 0.039), had higher baseline HCV RNA levels (p = 0.012), body mass index (BMI) ≥ 25 kg/m(2) (p = 0.034), significant liver fibrosis (p < 0.001), had been diagnosed with acquired immunodeficiency syndrome (AIDS)-defining criteria in the past (p = 0.001) and bore the HCV genotypes 1/4 (p = 0.046) when compared with SVR patients. The IL28B genotype was not associated with relapse. Multivariate binary logistic regression showed that high baseline HCV RNA, significant liver fibrosis, HCV genotypes 1/4, being overweight and being diagnosed with AIDS-defining criteria in the past were independently associated with relapse.
Our study shows that VR can be accurately predicted in HIV/HCV co-infected patients on the basis of risk factors which can be identified before treatment.
在人类免疫缺陷病毒（HIV）合并感染患者中，治疗结束后反应（ETR）后的丙型肝炎病毒（HCV）病毒复发（VR）在多达三分之一的合并感染患者中观察到。本研究的目的是确定接受聚乙二醇干扰素联合利巴韦林（PEG-INF/RBV）治疗的 HIV/HCV 合并感染患者 VR 的基线危险因素。
共前瞻性随访 212 例接受 PEG-INF/RBV 治疗的慢性丙型肝炎初治的高加索 HIV 感染患者。如果患者完成了完整的治疗疗程且达到 ETR，则将其纳入本前瞻性研究。我们评估了 VR 发生率与潜在复发预测因子之间的关系。
在随访的患者中，130 例（61.3%）达到 ETR，103 例（79.2%）达到持续病毒学应答（SVR）。因此，27 例（20.8%）出现 VR。复发的患者更多为男性（p=0.036），携带低密度脂蛋白受体（LDLr）基因中非 CC 型 rs14158 基因型（p=0.039），基线 HCV RNA 水平较高（p=0.012），体重指数（BMI）≥25 kg/m²（p=0.034），显著的纤维化（p＜0.001），过去曾被诊断为获得性免疫缺陷综合征（AIDS）定义标准（p=0.001），携带 HCV 基因型 1/4（p=0.046），与 SVR 患者相比。IL28B 基因型与复发无关。多变量二项逻辑回归显示，高基线 HCV RNA、显著纤维化、HCV 基因型 1/4、超重和过去被诊断为 AIDS 定义标准是复发的独立相关因素。
我们的研究表明，基于治疗前可识别的危险因素，可以准确预测 HIV/HCV 合并感染患者的 VR。
