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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Mandorfer, M; Neukam, K; Reiberger, T; Payer, BA; Rivero, A; Puoti, M; Boesecke, C; Baumgarten, A; Grzeszczuk, A; Zangerle, R; Meyer-Olson, D; Rockstroh, JK; Trauner, M; Pineda, JA; Peck-Radosavljevic, M.
The impact of interleukin 28B rs12979860 single nucleotide polymorphism and liver fibrosis stage on response-guided therapy in HIV/HCV-coinfected patients.
AIDS. 2013; 27(17): 2707-2714.
Doi: 10.1097/01.aids.0000432460.44593.ef
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- Co-authors Med Uni Graz
- Trauner Michael
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- Abstract:
- According to the European AIDS Clinical Society (EACS) guidelines for response-guided therapy (RGT) of chronic hepatitis C virus (HCV) infection in HIV-positive patients, HCV-genotype (GT) and rapid virologic response (RVR) exclusively determine the duration of antiviral therapy with pegylated interferon and ribavirin (PEGIFN+RBV). The aim of this study was to investigate the impact of interleukin 28B rs12979860 single nucleotide polymorphism (IL28B) and liver fibrosis stage on RGT in HIV/HCV-coinfected patients. Four hundred and thirty HIV/HCV-coinfected patients treated with PEGIFN+RBV were included in this multinational, retrospective analysis. Advanced liver fibrosis was defined as either METAVIR F3/F4 or liver stiffness more than 9.5 kPa. In patients with GT1/4 without RVR (GT1/4-noRVR), higher sustained virologic response (SVR) rates were observed in patients with extended treatment duration (48 weeks: 35% vs. 72 weeks: 60%; P = 0.008). In GT1/4-noRVR patients without advanced liver fibrosis (48 weeks: 45% vs. 72 weeks: 61%; P = 0.176), or with IL28B C/C (48 weeks: 48% vs. 72 weeks: 69%; P = 0.207), SVR rates did not vary significantly throughout the treatment duration subgroups. In contrast, in patients with advanced liver fibrosis (48 weeks: 11% vs. 72 weeks: 45%; P = 0.031), or IL28B non-C/C (48 weeks: 28% vs. 72 weeks: 56%; P = 0.011), extended treatment duration was associated with substantially higher SVR rates. GT2/3 patients with RVR (GT2/3-RVR) with shortened treatment duration (24 weeks) displayed SVR rates ranging from 83 to 100%, regardless of IL28B and liver fibrosis stage. Our study confirms the concept of RGT in HIV/HCV coinfection and supports the extension of therapy duration to 72 weeks for patients with GT1/4-noRVR, especially in patients with IL28B non-C/C or advanced liver fibrosis. The results of our study strongly support the shortening of therapy duration to 24 weeks in GT2/3-RVR patients, regardless of IL28B and advanced liver fibrosis.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Antiviral Agents - administration & dosage
- Coinfection - drug therapy Coinfection - genetics Coinfection - pathology
- Drug Therapy, Combination - methods
- Female -
- HIV Infections - complications
- Hepatitis C, Chronic - drug therapy
- Humans -
- Interferons - administration & dosage
- Interleukins - genetics
- Liver Cirrhosis - genetics Liver Cirrhosis - pathology
- Male -
- Middle Aged -
- Polymorphism, Single Nucleotide -
- Prognosis -
- Retrospective Studies -
- Ribavirin - administration & dosage
- Time Factors -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- HIV
- HCV coinfection
- interleukin 28B rs12979860 single nucleotide polymorphism
- liver fibrosis
- pegylated interferon
- response-guided therapy
- ribavirin