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Background  HIV infection leads to a faster progression of liver disease in subjects infected with HCV, as compared with HCV mono-infected patients. Previous reports suggest that sustained virological response (SVR) rates are lower in HIV/HCV coinfection than in HCV monoinfection. We aimed to compare SVR rates of these two populations.    Methods  We retrospectively analyzed clinical, biochemical and virological data of HCV and HIV/HCV infected patients with HCV genotypes 2 and 3 who started anti-HCV treatment between March 2004 and November 2012, at a single large center. Intention-to-treat (ITT) and per-protocol (PP) analysis were performed. Univariate and multivariate logistic regression analyses were performed to assess predictors of SVR.    Results  461 patients were analyzed: 307 (66.6%) males, 76 (16.5%) infected with HIV. Several differences at baseline between HCV monoinfected and HIV/HCV coinfected patients were observed. HCV monoinfected group was characterized by higher prevalence of genotype 2 (53%  vs  5.3%), higher baseline HCV viral load (50%  vs  35%), shorter mean duration of treatment (19  vs  41 weeks), more frequent use of peginterferon alfa-2a (84.5%  vs  69.7%), lower prevalence of cirrhosis (6%  vs  31.6%). Globally, SVR was achieved by 353 (76.6%) patients and 321 (83.8%) in the PP analysis. No statistically relevant differences were found in SVR rates between the two groups, either in ITT [78.2% (n = 301/385)  vs  68.4% (n = 52/76),  p = 0.066, respectively] than in PP analysis [83.6% (n = 276/330)  vs  84.9% (n = 45/53),  p =  0.8].   ITT analysis  At univariate and multivariate analysis, baseline HCV-RNA >500.000 IU/ml [OR 0.4 (0.24-0.66),  p  = 0.0004], use of peginterferon alfa-2b [OR 0.5 (0.27-0.93)  p  = 0.033], platelets count <130.000/mm 3  [OR 0.45 (0.2-0.99),  p  = 0.045], interruption of peginterferon therapy [OR 0.2 (0.1-0.4),  p <0.0001], interruption of ribavirin treatment [OR 0.34 (0.17-0.69),  p  = 0.0026] were related with lower rate of SVR.    PP analysis  Only HCV-RNA >500.000 IU/ml and interruption of ribavirin were related to lower probability to achieve SVR at both univariate and multivariate analysis [OR 0.41 (0.23-0.75),  p  = 0.004; OR 0.24 (0.1-0.5),  p  = 0.0004, respectively].Conclusions  Higher baseline viral loads and interruption of peginterferon and/or ribavirin were associated with a poor outcome of anti-HCV treatment while HIV infection was not related to major or minor probability to achieve SVR.

Sustained virological response to peginterferon therapy in patients infected with HCV (genotypes 2 and 3), with or without HIV