Modeling the Probability of Sustained Virological Response to Therapy with Pegylated Interferon plus Ribavirin in Patients Coinfected with Hepatitis C Virus and HIV

Abstract

The probability of achieving sustained virological response with pegIFN-RBV therapy in HIV-HCV-coinfected patients can be reliably estimated prior to initiation of therapy using an index that includes 4 noninvasive parameters.

Prediction of response to pegylated interferon plus ribavirin in HIV/hepatitis C virus (HCV)-coinfected patients using HCV genotype, IL28B variations, and HCV-RNA load

“…3). The predictive performance of this algorithm is somewhat lower than that yielded by the Prometheus model, which, in addition to these three parameters, also evaluates liver stiffness, as determined by transient elastometry [15]. However, the Prometheus index does not differentiate between genotype 1 and 4.…”

Different impact of IL28B polymorphisms on response to peginterferon-α plus ribavirin in HIV-positive patients infected with HCV subtypes 1a or 1b

“…The disproportion between HCV-1a and HCV-1b in our population just reflects the slightly higher prevalence of HCV-1a vs HCV-1b in HIV/HCV-coinfected patients in Europe, mainly as result of the predominance of HCV-1a in the large epidemic among intravenous drug users in the eighties. 4 In our knowledge, our study reports for the first time a differential impact of IL28B polymorphisms on distinct HCV-1 subtypes. The rate of SVR in patients with CC alleles was the same (63-64%) regardless HCV-1 variants, while treatment responses in CT/TT carriers were only significantly reduced in HCV-1a (20%) but not in HCV-1b (46%).…”

“…1,2 More recently, IL28B polymorphisms have also demonstrated to strongly predict treatment outcome. 3,4 In less extent, substitutions at viral core and NS5A residues may also influence treatment outcomes. 23,24 The information available suggest that all these variables will remain as predictors of response to new direct antiviral agents against HCV, 5-8 most likely because these drugs will initially be given as third agent along with pegIFN/RBV.…”

“…[1][2][3][4] These variables remain as poor predictors of response to triple combination therapy including either boceprevir or telaprevir. [5][6][7][8] Interestingly, HCV subtype 1a has emerged as a new predictor of poor response to triple therapy including telaprevir or boceprevir, which largely has been attributed to a lower barrier to resistance in HCV-1a than HCV-1b, driven by differences at the HCV protease codon 155 nucleotides.…”

HCV and HIV Coinfection

“…Beyond the relevance for the investigation of new therapeutic strategies against HCV, which may include IFN-λ3, the recognition that IL28B polymorphisms may influence natural HCV clearance as well as virus elimination following IFN-based therapies, supports that IL28B genotyping should be incorporated as part of the HCV treatment decision algorithm in HIV/HCV coinfected patients. In this regard, we recently built a freely accessible algorithm, known as the Prometheus index, that allows prediction of the likelihood of SVR using four different baseline features (HCV genotype, HCV load, IL28B genotype, and liver fibrosis stage) [31].…”