Benefits From Sustained Virologic Response to Pegylated Interferon Plus Ribavirin in HIV/Hepatitis C Virus–Coinfected Patients With Compensated Cirrhosis

Abstract

The achievement of SVR following peg-IFN plus RBV markedly reduces the incidence of liver-related decompensation and the overall mortality in HIV/HCV-coinfected patients with compensated cirrhosis.

Incidence and predictors of cardiovascular disease, chronic kidney disease, and diabetes in HIV/HCV-coinfected patients who achieved sustained virological response

“…However, in the Cox regression model, we did not find any significant difference between patients who achieved an SVR and those who did not. Particularly, in contrast to the observations of other studies, the achievement of SVR following INF therapy was not significantly associated with a reduction in the risk of death [3,4]. Our results can be partly explained by the sample size of treated patients (20 % out of all enrolled patients) and different INF-based regimens (peg-IFN or standard thriceweekly INF plus RBV) that have been used in the 15-year period of enrolment in the cohort.…”

“…HIV/hepatitis C virus (HCV)-coinfected patients have accelerated progression of HCV-related liver disease and increased mortality rate compared to HCV-or HIV-monoinfected patients. There is increasing evidence that the achievement of sustained virologic response (SVR) after pegylated interferon (peg-IFN) plus ribavirin (RBV) treatment reduces the incidence of hepatocellular carcinoma (HCC), liver decompensation, and overall mortality in HIV/HCV-coinfected patients [3][4][5][6]. Although HCV coinfection is associated with an increased risk of cardiovascular disease (CVD), chronic kidney disease (CKD), and diabetes mellitus (DM) among HIV-infected patients, the impact of SVR on the risk of the development of extrahepatic complications has been little investigated [7][8][9].…”

Fibrosis Regression Explains Differences in Outcome in HIV-/HCV-Coinfected Patients with Cirrhosis After Sustained Virological Response

“…Liver biopsy had been performed in 92 cases (69 %), a median time of 165 days (43-1043) before therapy. All the patients had fibrosis 4, and the median histological activity index (HAI) was 5.84 (4)(5)(6)(7)(8)(9)(10)(11)(12). The remaining 41 patients had a LSM before therapy confirming fibrosis 4.…”

“…Cumulative evidence demonstrates that SVR is associated with a lower rate of complications [6][7][8]. However, in spite of a lower risk, patients with cirrhosis are not entirely protected against the risk of liver complications or of developing HCC after SVR [9][10][11].…”

Current and future challenges in HCV: insights from an Italian experts panel

“…All these treatments have high rates of virologic response similar to those obtained in patients with HCV infection alone. In the era of highly effective antiretroviral therapies, HIV response does not seem to be affected by co-infection [84] and HCV virologic cure has been shown to reduce the risk of liver-related outcomes, including liver decompensation and mortality [85,86]. The potential contribution of HCV to HIV disease pathogenesis still remains poorly understood.…”