Study Shows Value of Hepatitis C Therapy for HIV Co-infected Patients with Compensated Cirrhosis

Spanish researchers report success in treating HIV- and hepatitis C-coinfected people with compensated cirrhosis—those whose livers are still functioning—with pegylated interferon and ribavirin. Patients who achieved a sustained virologic response (SVR) from hepatitis C treatment had reduced risk of decompensated cirrhosis and liver-related death, according to study authors. SVR essentially means the patient is cured—hepatitis C is undetectable 24 weeks after treatment is completed.

To reach these conclusions, the research team reviewed the records of 166 HIV- and hepatitis C-coinfected patients with compensated cirrhosis who received 48 weeks of treatment with pegylated interferon and ribavirin between 2001 and 2011. The team compared progression to decompensated cirrhosis and rates of death between patients who achieved SVR and those who did not. A quarter of the study cohort reached SVR, and 21 percent progressed to decompensated cirrhosis. Of those who achieved SVR, only five percent progressed to decompensated cirrhosis, whereas 27 percent who did not achieve SVR progressed to decompensated cirrhosis. After three years, patients with SVR had a four-percent risk of developing decompensated cirrhosis, and patients without SVR had a 32-percent risk of decompensated cirrhosis.

Reaching SVR did not reduce the risk of liver cancer, according to researchers. However, SVR did cut the three-year risk of death compared to those who did not respond to treatment (three percent compared to 20 percent, respectively). Overall, 10 percent of study participants died of liver failure. Hepatitis C causes scarring—cirrhosis—of the liver, which can eventually cause liver failure and death.

The full report, “HIV/AIDS: Benefits from Sustained Virological Response to Pegylated Interferon Plus Ribavirin in HIV/HCV-Coinfected Patients with Compensated Cirrhosis,” was published online in the journal Clinical Infectious Diseases (2013;10.1093/cid/cit103).

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