Ribavirin Concentrations Do Not Predict Sustained Virological Response in HIV/HCV-Coinfected Patients Treated with Ribavirin and Pegylated Interferon in the Swiss HIV Cohort Study.

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Serval ID
serval:BIB_9DFD442A4AF5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ribavirin Concentrations Do Not Predict Sustained Virological Response in HIV/HCV-Coinfected Patients Treated with Ribavirin and Pegylated Interferon in the Swiss HIV Cohort Study.
Journal
Plos One
Author(s)
Kovari H., Russmann S., Ledergerber B., Müller D., Rotger M., Velli P., Cavassini M., Ambrosioni J., Bregenzer A., Stöckle M., Bernasconi E., Rauch A., Speck R.F.
Working group(s)
Swiss HIV Cohort Study
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
10
Number
7
Pages
e0133879
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural Publication Status: epublish
Abstract
BACKGROUND: Ribavirin (RBV) is an essential component of most current hepatitis C (HCV) treatment regimens and still standard of care in the combination with pegylated interferon (pegIFN) to treat chronic HCV in resource limited settings. Study results in HIV/HCV-coinfected patients are contradicting as to whether RBV concentration correlates with sustained virological response (SVR).
METHODS: We included 262 HCV treatment naïve HIV/HCV-coinfected Swiss HIV Cohort Study (SHCS) participants treated with RBV and pegIFN between 01.01.2001-01.01.2010, 134 with HCV genotype (GT) 1/4, and 128 with GT 2/3 infections. RBV levels were measured retrospectively in stored plasma samples obtained between HCV treatment week 4 and end of therapy. Uni- and multivariable logistic regression analyses were used to evaluate the association between RBV concentration and SVR in GT 1/4 and GT 2/3 infections. The analyses were repeated stratified by treatment phase (week 4-12, 13-24, >24) and IL28B genotype (CC versus CT/TT).
RESULTS: SVR rates were 35.1% in GT 1/4 and 70.3% in GT 2/3 infections. Overall, median RBV concentration was 2.0 mg/L in GT 1/4, and 1.9 mg/L in GT 2/3, and did not change significantly across treatment phases. Patients with SVR had similar RBV concentrations compared to patients without SVR in both HCV genotype groups. SVR was not associated with RBV levels ≥2.0 mg/L (GT 1/4, OR 1.19 [0.5-2.86]; GT 2/3, 1.94 [0.78-4.80]) and ≥2.5 mg/L (GT 1/4, 1.56 [0.64-3.84]; GT 2/3 2.72 [0.85-8.73]), regardless of treatment phase, and IL28B genotype.
CONCLUSION: In HIV/HCV-coinfected patients treated with pegIFN/RBV, therapeutic drug monitoring of RBV concentrations does not enhance the chance of HCV cure, regardless of HCV genotype, treatment phase and IL28B genotype.
Keywords
Adult, Antiviral Agents/therapeutic use, Coinfection/blood, Coinfection/complications, Drug Monitoring, Drug Therapy, Combination, Female, Follow-Up Studies, Genotype, HIV Infections/blood, HIV Infections/complications, HIV-1/drug effects, Hepacivirus/drug effects, Hepatitis C, Chronic/blood, Hepatitis C, Chronic/complications, Humans, Interferon-alpha/therapeutic use, Male, Middle Aged, Polyethylene Glycols/therapeutic use, Prospective Studies, Recombinant Proteins/therapeutic use, Ribavirin/blood, Ribavirin/therapeutic use, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
27/08/2015 9:38
Last modification date
20/08/2019 15:04
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