Effect of Aging, Glucose Level, and HIV Viral Load on Response to Treatment with Pegylated Interferon Plus Ribavirin in HIV/HCV Co-Infected Women
Publication: Journal of Women's Health
Volume 24, Issue Number 2
Abstract
Background: This was a post-hoc analysis of the Optimized Pegylated interferons Efficacy and anti-Retroviral Approach (OPERA) study, originally designed to document routine clinical and treatment data in HIV/HCV coinfected patients treated with pegylated interferon/ribavirin (PEG-IFN/RBV). The aim of this study was to define the impact of several variables, such as age, glucose metabolism, and HIV viral load, on PEG-IFN/RBV treatment outcomes, in HIV/HCV coinfected women.
Methods: Female subjects from the OPERA database were retrospectively evaluated and factors associated with sustained virological response (SVR) were assessed and compared to the male population by logistic regression analysis. At baseline, clinical and demographic data were collected. Patients were then administered with PEG-IFN/RBV therapy for 48 weeks. After a 24-week follow-up period, SVR was evaluated.
Results: A total of 1523 patients were enrolled in 98 centers across Italy, 1284 of whom were IFN therapy naïve and were included in the post-hoc analysis. In the female group, factors associated with SVR were the presence of HCV genotype 2,3 (adjusted odds ratio [AOR]=6.87, p<0.0001), age ≤45 years (AOR=2.61, p=0.014), ≥80% exposure to PEG-IFN (AOR=3.85, p=0.019) and RBV (AOR=3.94, p=0.015) therapy. Also, increased glucose plasma level negatively correlated with SVR (AOR=0.98, p=0.066). In the male population, undetectable HIV-RNA (AOR=1.47, p=0.033) but not glucose level (AOR=1.0, p=0.95) predicted SVR.
Conclusions: Findings from the present study demonstrate that several factors may be predictive of SVR when pegylated interferon plus ribavirin is used (i.e., age, gender, HIV viral load and HCV genotype) that need to be carefully considered prior to therapeutic intervention, since they may hinder successful therapy. Use of PEG-IFN/RBV with novel direct antiviral agents will likely be still maintained until less expensive and effective interferon-free strategies become available.
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Copyright 2015, Mary Ann Liebert, Inc.
History
Published online: 15 February 2015
Published ahead of print: 3 February 2015
Published in print: February 2015
Authors
Author Disclosure Statement
Paola Nasta received speaking honoraria from Bristol-Myers Squibb, Merck Sharp and Dohme, Janssen-Cilag, and ViiV Healthcare. Gabriella Verucchi received speaking honoraria from Roche, Merck Sharp and Dohme, Bristol-Myers Squibb and Gilead. Antonietta Caputo is an employee of Roche. Claudio Iannacone (SPARC Consulting) received consulting fees and honorarium from Roche for participation in board activities, statistical analysis, manuscript writing, and reviewing. Massimo Puoti received consulting fees and speaking honoraria from Roche for participation in board activities, in own events and in training courses for internal personnel. Giampiero Carosi has received speaking honoraria from Bristol-Myers Squibb, Janssen-Cilag, and ViiV Healthcare. All remaining authors declare that no competing financial interest exist.
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