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Impact of different ART regimens on efficacy and safety of standard HCV treatment in HIV/HCV co-infected patients
Presented by Pavel Khaykin, Germany.
Khaykin P.1, Vogel M.2, Voigt E.2, Rockstroh J.2, Carlebach A.3, Lutz T.3, Staszewski S.1
1University of Frankfurt, HIVCENTER, HIV Treatment & Clinical Research Unit, Frankfurt on Main, Germany, 2University Hospital Bonn, Department of Internal Medicine I, Bonn, Germany, 3Private Practice Friedenstrasse, Frankfurt on Main, Germany
Objectives: The aim of our research was a comparison of the virologic response as well as the safety of standard HCV-treatment with peginterferon and ribavirin in HIV/HCV co-infected patients treated with different ART regimens.
Methods: Retrospective multicenter study. 230 HIV/HCV co-infected patients treated with peginterferon und ribavirin. Patients were grouped according to their HAART regimen at baseline: NRTI-free (group A), NRTI-friendly (no AZT, d4T or ddI, group B), or NRTI-containing HAART including AZT, ddI or d4t (group C). 85/230 were ART naïve, 29 patients were taking NRTI-free therapy (boosted double PI regimens), 19 patients had NRTI-“friendly” ART without zidovudine (AZT), stavudine (d4t) or didanosine (ddI), and 97 patients had NRTI treatment including AZT or d4t or ddI. The baseline characteristics such as age, sex, and HCV-genotype were comparable among the groups. Primary endpoints were the rates of end-of-treatment virological response and the rate of discontinuation of treatments.
Results: Our findings reveal the following virologic responses: undetectable HCV viral load was observed in 54.3% of ART-naïve patients; in 66% patients who were treated with NRTI-free regimens; in 47.8% with NRTI-friendly therapy; and in 35.4% cases for patients who received AZT or d4t or ddI (c2=11.1, p=0.01). HCV-treatment discontinuation was observed in 41.9% of ART naïve patients, in 18.5% of patients with NRTI-free therapy, in 26.1% with NRTI-friendly therapy, and in 54.2 % who received AZT-, d4t- or ddI-containing treatment (c2=14.2, p=0.003).
Conclusions: HCV/HIV co-infected patients treated with NRTI-free or NRTI-friendly ART therapy demonstrated better virological response and better tolerability to the standard peginterferon und ribavirin treatment compared to patients who were received AZT-, d4t- or ddI-containing regimens.
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