Clinical progression, survival, and immune recovery during antiretroviral therapy in patients with HIV-1 and hepatitis C virus coinfection: the Swiss HIV Cohort Study

Détails

ID Serval
serval:BIB_D7137673455B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinical progression, survival, and immune recovery during antiretroviral therapy in patients with HIV-1 and hepatitis C virus coinfection: the Swiss HIV Cohort Study
Périodique
Lancet
Auteur(s)
Greub  G., Ledergerber  B., Battegay  M., Grob  P., Perrin  L., Furrer  H., Burgisser  P., Erb  P., Boggian  K., Piffaretti  J. C., Hirschel  B., Janin  P., Francioli  P., Flepp  M., Telenti  A.
ISSN
0140-6736 (Print)
Statut éditorial
Publié
Date de publication
11/2000
Volume
356
Numéro
9244
Pages
1800-5
Notes
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Nov 25
Résumé
BACKGROUND: Hepatitis C virus (HCV) infection is highly prevalent among HIV-1-infected individuals, but its contribution to the morbidity and mortality of coinfected patients who receive potent antiretroviral therapy is controversial. We used data from the ongoing Swiss HIV Cohort Study to analyse clinical progression of HIV-1, and the virological and immunological response to potent antiretroviral therapy in HIV-1-infected patients with or without concurrent HCV infection. METHODS: We analysed prospective data on survival, clinical disease progression, suppression of HIV-1 replication, CD4-cell recovery, and frequency of changes in antiretroviral therapy according to HCV status in 3111 patients starting potent antiretroviral therapy. RESULTS: 1157 patients (37.2%) were coinfected with HCV, 1015 of whom (87.7%) had a history of intravenous drug use. In multivariate Cox's regression, the probability of progression to a new AIDS-defining clinical event or to death was independently associated with HCV seropositivity (hazard ratio 1.7 [95% CI 1.26-2.30]), and with active intravenous drug use (1.38 [1.02-1.88]). Virological response to antiretroviral therapy and the probability of treatment change were not associated with HCV serostatus. In contrast, HCV seropositivity was associated with a smaller CD4-cell recovery (hazard ratio for a CD4-cell count increase of at least 50 cells/microL=0.79 [0.72-0.87]). INTERPRETATION: HCV and active intravenous drug use could be important factors in the morbidity and mortality among HIV-1-infected patients, possibly through impaired CD4-cell recovery in HCV seropositive patients receiving potent antiretroviral therapy. These findings are relevant for decisions about optimum timing for HCV treatment in the setting of HIV infection.
Mots-clé
AIDS-Related Opportunistic Infections/*drug therapy Adolescent Adult Anti-HIV Agents/*therapeutic use CD4 Lymphocyte Count Cohort Studies Disease Progression Female Hepatitis C/complications/*drug therapy Humans Male Middle Aged Prospective Studies Survival Analysis Switzerland Viral Load Viremia/etiology
Pubmed
Web of science
Création de la notice
25/01/2008 17:08
Dernière modification de la notice
20/08/2019 15:56
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