SHS measured by CAP is highly prevalent among HIV-infected patients. High BMI is the main predictor of SHS in this setting.

It is commonly accepted that human immunodeficiency (HIV) coinfection negatively impacts on the rates of sustained virological response (SVR) to therapy with pegylated interferon plus ribavirin (PR). However, this hypothesis is derived from comparing different studies. The aim of this study was to determine the impact of HIV coinfection on SVR to PR in one single population. In a multicentric, prospective study conducted between 2000 and 2013, all previously naïve hepatitis C virus (HCV)-infected patients who started PR in five Spanish hospitals were analyzed. SVR was evaluated 24 weeks after the scheduled end of therapy. Of the 1046 patients included in this study, 413 (39%) were coinfected with HIV. Three hundred and forty-one (54%) HCV-monoinfected versus 174 (42%) HIV/HCV-coinfected patients achieved SVR (p < 0.001). The corresponding figures for undetectable HCV RNA at treatment week 4 were 86/181 (47%) versus 59/197 (30%), p < 0.001. SVR was observed in 149 (69%) HCV genotype 2/3-monoinfected subjects versus 91 (68%) HIV/HCV genotype 2/3-coinfected subjects (p = 0.785). In the HCV genotype 1/4-infected population, 188 (46%) monoinfected patients versus 82 (30%) with HIV coinfection (p < 0.001) achieved SVR. In this subgroup, absence of HIV coinfection was independently associated with higher SVR [adjusted odds ratio (95% confidence interval): 2.127 (1.135-3.988); p = 0.019] in a multivariate analysis adjusted for age, sex, baseline HCV RNA load, IL28B genotype, fibrosis stage, and type of pegylated interferon. HIV coinfection impacts on the rates of SVR to PR only in HCV genotype 1/4-infected patients, while it has no effect on SVR in the HCV genotype 2/3-infected subpopulation.

In treatment-naive/-experienced HCV-1/HIV-1 patients there were significantly higher SVR rates with telaprevir-based therapy compared with pre-specified historical controls, and safety comparable to that in HCV-monoinfected patients.

Spain’s rate of new human immunodeficiency virus (HIV) diagnoses exceeds that of the European Economic Area average (8.6 vs 5.6:100,000 in 2018). The country has failed to meet the first of United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets for HIV control by 2020, with 87.0% of people living with HIV knowing their status, and late presentation rates of 47.6% and 51.5% country-wide and in the Valencian autonomous community, respectively. Advancing screening and linkage to care (SLTC) practices is necessary to effectively control the epidemic. The Valencia Viral Screening (CRIVALVIR) project adopted the TEST model for opportunistic and systematic HIV SLTC in individuals aged 18 to 80 who required blood work for any purpose, as of February 2019. SLTC was integrated into routine clinical workflow across primary care centers serving a population of 360,000 people in Valencia, Spain. Our project successfully upscaled total HIV testing by 194% to over 32,000 patients tested in 14 months. We found an overall prevalence of 0.13% (0.08–0.21) among those screened per protocol (n = 13,061), with foreign-born citizens presenting a 12.5 times significantly higher likelihood of acquiring HIV (95% confidence interval 4.63–33.96, P < .0001). We improved late presentation by 18.2 percentage points and prevented an estimated 58 to 70 new secondary infections. HIV screening of the general population in primary care is an effective strategy for achieving timely diagnosis and preventing new infections. Opportunistic, systematic, opt-out approaches are essential to control the HIV epidemic.

Background Interleukin-28B genetic polymorphism is a key predictor of response to peginterferon-ribavirin treatment in hepatitis C virus (HCV) genotype 1 infection (HCVg1i), CC interleukin-28B genotype (IL28Bg) being highly predictive of efficacy. There is a range of genotypes as well as responses to treatment, for example see the REALISE study . Main genotypes are IL28Bg CT, CC and TT. Purpose To assess the role of IL28Bg as a predictor of response in HCVg1i patients treated with telaprevir-based treatment. Materials and methods Retrospective study of patients treated with peginterferon-ribavirin-telaprevir. Demographic and pathological data, response at 4 and 12 weeks (HCV-RNA <1000) and at 24, 36, 48 weeks of treatment (HCV-RNA undetectable), sustained virological response 12 weeks after treatment (SVR12), adverse effects and discontinuation were collected in an Access database and analysed with SPSS vs12. Results 73 patients (53 male), median age of 51 (34–76) years, 63.4% genotype 1b, 87.7% mono-infected, 68.5% pretreated (mainly relapsers 60%), and 56.2% fibrosis F3-F4. 65.8% were IL28Bg CT, 19.2% CC, 15.1% TT. 32.9% discontinued treatment. Among IL28Bg groups no difference was found either in baseline data or in response at 4,12, 24, 36 and 48 weeks of treatment and SVR12, but a lower response in TT individuals was observed in weeks 36 and 48 (85.7% vs. 100% in CT and CC) and lower SVR12 with a virological failure in TT (33.3%) and CT (12.5%), not being observed in CC. Anaemia (haemoglobin level <10 g/dL) was more frequent in CC (50%) nevertheless significant differences were not observed. There was no difference in cutaneous rash. Within each group, discontinuation was higher in CT (35.4%) and CC (35.7%) being mainly due to virological failure (52.9%) and adverse effects (60%), respectively. Conclusions IL28Bg seemed to show a very good SVR12 in the CC group, an increase in virological failure being observed in CT and TT. Published studies suggest that the IL28B genotype has a limited impact on sustained virological response (SVR) rates with telaprevir-based treatment, achieving an improvement in all IL28B genotypes. In our study SVR12 might be influenced by IL28Bg. Further SVR data is needed. No conflict of interest.