Viral kinetics and early prediction of nonresponse to peg-IFN-α-2b plus ribavirin in HCV genotypes 1/4 according to HIV serostatus†

  1. A. Moreno1,
  2. R. Bárcena2,
  3. S. García-Garzón2,
  4. L. Moreno1,
  5. C. Quereda1,
  6. A. Muriel3,
  7. J. Zamora3,
  8. M. L. Mateos4,
  9. M. J. Pérez-Elías1,
  10. A. Antela1,
  11. S. Diz1,
  12. A. Moreno5,
  13. S. Moreno1

Article first published online: 16 MAR 2006

DOI: 10.1111/j.1365-2893.2005.00710.x

Issue

Journal of Viral Hepatitis

Journal of Viral Hepatitis

Volume 13, Issue 7, pages 466–473, July 2006

Additional Information

How to Cite

Moreno, A., Bárcena, R., García-Garzón, S., Moreno, L., Quereda, C., Muriel, A., Zamora, J., Mateos, M. L., Pérez-Elías, M. J., Antela, A., Diz, S., Moreno, A. and Moreno, S. (2006), Viral kinetics and early prediction of nonresponse to peg-IFN-α-2b plus ribavirin in HCV genotypes 1/4 according to HIV serostatus. Journal of Viral Hepatitis, 13: 466–473. doi: 10.1111/j.1365-2893.2005.00710.x

Author Information

  1. 1

    From the Services of Infectious Diseases

  2. 2

    Liver-Gastroenterology

  3. 3

    Clinical Biostatistics

  4. 4

    Microbiology

  5. 5

    Pathology, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain

*Ana Moreno, Servicio de Enfermedades Infecciosas, Hospital Ramon y Cajal, Ctra, Colmenar, Km. 9,100, 28034 Madrid, Spain. E-mail: amoreno.hrc@salud.madrid.org

  • †

    Presented in part at the 11th Conference on Retroviruses and Opportunistic Infections, San Francisco, CA, February 8–11, 2004.

Publication History

  1. Issue published online: 16 MAR 2006
  2. Article first published online: 16 MAR 2006
  3. Received March 2005; accepted for publication June 2005

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Keywords:

  • cut-off;
  • HCV-RNA kinetics;
  • human immunodeficiency virus;
  • pegylated interferon/ribavirin

Summary.  To evaluate, among 70 hepatitis C virus (HCV)-monoinfected and 36 human immunodeficiency virus (HIV)-coinfected naïve patients with genotypes 1/4 receiving weight-adjusted pegylated interferon-α-2b/ribavirin, viral kinetics and the feasibility to predict treatment failure measuring early HCV-RNA decreases. HCV-RNA was assessed at baseline, weeks 4, 12 and 24. Receiver operating characteristic (ROC) curves were calculated to determine the most sensitive cut-off values of viral decrease at week 4 predicting treatment failure. Baseline predictors of failure were evaluated by univariate and multivariate analyses. Despite similar baseline HCV-RNA (5·75 vs 5·72 log10IU/ml, P = 0·6), HCV monoinfection led to significantly lower HCV-RNA values at weeks 4 (3·7 vs 4·3 log10IU/ml, P = 0·01), 12 (2·3 vs 3·5 log10IU/ml, P = 0·01) and 24 (1·4 vs 3·3 log10IU/ml, P = 0·001) and a higher rates of viral clearance at weeks 24 (60%vs 36%, P = 0·02), 48 (46%vs 25%, P = 0.03) and 72 (37%vs 17%). The lack of achieving an HCV-RNA decrease of at least 1 log10 at week 4 was highly predictive of treatment failure for HCV-monoinfected patients (Se 100%, Sp 50%, positive predictive value (PPV) 57%, negative predictive value (NPV) 100%, ROC curve area, 0·86 [95% confidence interval (CI) 0·77–0·95], but not for HCV/HIV-coinfected patients (cut-off, 0 log10, Se 100%, Sp 27%, PPV 21%, NPV 100%, ROC curve area, 0·71 (95% CI 0·49–0·93). HIV coinfection was independently associated with failure (odds ratio 2.95, 95% CI 1·08–8.04, P = 0·01). Thus the magnitude of HCV-RNA decreases at week 4 correlated with treatment response. Significant differences in viral kinetics and cut-off values predicting nonresponse suggest a slower HCV clearance rate in HIV coinfection, which was independently associated with treatment failure.

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