Abstract

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Rate of cirrhosis progression reduced in HIV/HCV co-infected non-responders to anti-HCV therapy

Presented by Caterina Uberti-Foppa, Italy.

De Bona A.¹, Galli L.¹, Gallotta G.¹, Alagna L.¹, Lazzarin A.¹, Uberti-Foppa C.¹

¹San Raffaele Hospital, Scientific Institute, Vita-Salute University, Infectious diseases, Milan, Italy

Objectives: The clinical impact of pegylated interferon (peg-IFN) and ribavirin on the rate of cirrhosis progression in HIV/HCV co-infected non-responders to anti-HCV drugs is currently unknown.
Methods: This is a retrospective longitudinal follow-up study of 25 HIV/HCV positive cirrhotic outpatients not responding to peg-IFN plus ribavirin, and 25 untreated controls matched for age (± 5 years), gender and Child-Pugh score.The primary endpoint of the study was the incidence of cirrhosis progression (CP) defined as the occurrence of at least one of the following events: death, ascites, jaundice, encephalopathy, gastrointestinal bleeding and hepatocellular carcinoma (HCC).
Results: The median duration of anti-HCV therapy was nine months (range 5-12). The treated and untreated patients were comparable in terms of alcohol intake, CDC classification, HAART, and the presence of esophageal varices. During the median follow-up of 54 months (34-89), four treated (16%) and 13 untreated patients (52%) experienced CP (p=0.02). The respective incidence rates were 7.7 per 100 PYFU (95% CI: 1.8-33.1) for a total of 65 PYFU, and 65.1 per 100 PYFU (95% CI: 4.4-964.8) for a total of 51 PYFU. Poisson’s regression model showed that the independent predictors of CP were Peg-IFN therapy (adjusted RR=0.03; 95% CI: 0.002-0.512; p=0.016), positive HIV-RNA (adjusted RR=35.98; 95% CI: 1.594-812.0; p=0.024), and altered ALP values (adjusted RR=25.5; 95% CI: 2.02-320.8; p=0.012).
Conclusions: Peg-IFN therapy seems to slow down the rate of cirrhosis progression also in HIV/HCV co-infected patients non-responders to anti-HCV therapy, in comparison with untreated patients.

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