TITLE

Sustained Virological Response and Baseline Predictors in HIV-HCV Coinfected Patients Retreated with Pegylated Interferon and Ribavirin after Failing a Previous Interferon-Based Therapy: Systematic Review and Meta-Analysis

AUTHOR(S)
Basso, Monica; Parisi, Saverio Giuseppe; Mengoli, Carlo; Gentilini, Valeria; Menegotto, Nicola; Monticelli, Jacopo; Nicolè, Stefano; Cruciani, Mario; Palù, Giorgio
PUB. DATE
July 2013
SOURCE
HIV Clinical Trials;Jul/Aug2013, Vol. 14 Issue 4, p127
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Published data on retreatment with pegylated interferon and ribavirin of previously failing HIV-HCV coinfected patients are sparse and limited to observational study. We aimed to evaluate efficacy and pretreatment predictors. Methods: Systematic review and meta-analysis of observational studies. The overall and genotype-related success rate was investigated. A direct comparison was performed between genotypes 1/4 and 2/3 by evaluating the sustained virological response (SVR) rate ratio (RR). The effect of study level variables on the effect size was investigated by meta-regression. Variables that were analyzed included age, gender, advanced hepatic fibrosis, pretreatment of HCV RNA and CD4, and successful antiretroviral treatment (ART). Results: The available evidence was from 5 open-label, cohort studies (275 patients). The overall SVR rate was 0.280 (95% CI,0.171-0.425). The SVR rate in genotype 1/4 infections was 0.174 (95% CI, 0.129-0.230), and in genotype 2/3 infections it was 0.474 (95% CI, 0.286-0.670). The pooled RR comparing the SVR of genotype 1/4 to 2/3 was 0.369 (95% CI, 0.239-0.568), with a decreased probability of response for genotype 1/4 (P < .001). HIV RNA suppression had a significant effect on SVR (P = .005). The other covariates had no effect on the overall SVR rate. Conclusions: The overall SVR rate was 28%, consistent with the rate reported in the retreatment of mono-infected patients with the same schedule. A substantial relative reduction in the SVR rate of about one-third, when treating genotypes 1/4, was found, with a low SVR rate of 17%. Successful HIV suppression by ART predicted a higher rate of treatment success.
ACCESSION #
93702860

 

Related Articles

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics