Hepatic histologic response (HR) to combination therapy among HCV/HIV-coinfected individuals: interferon induces HR independent of sustained virologic response (SVR).

Hepatic histologic response (HR) to combination therapy among HCV/HIV-coinfected individuals: interferon induces HR independent of sustained virologic response (SVR).
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HCV/HIV 合并感染个体对联合治疗的肝组织学反应 (HR):干扰素诱导 HR 独立于持续病毒学反应 (SVR)。

DOI:
10.1089/aid.2006.22.1091
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发表时间:
2006
影响因子:
1.5
通讯作者:
Polis,MichaelA
Polis,MichaelA
中科院分区:
医学4区
文献类型:
--
作者:
Wu,Lynne;Kottilil,Shyam;Lempicki,Richard;Yang,Jun;McLaughlin,Mary;Hu,Zonghui;Koratich,Chad;Reitano,KristinN;Rehm,CatherineA;Masur,Henry;Wood,Brad;Kleiner,DavidE;Polis,MichaelA

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Most HIV/HCV-coinfected patients fail to achieve a sustained virologic response (SVR) to peginterferon-ribavirin therapy. We examined the hepatic histologic response (HR), defined as an improvement in hepatic inflammation scores of two points or more, to combination therapy among HIV/HCV-coinfected subjects. An open label prospective trial treated 32 HIV/HCV-coinfected patients with peginterferon alpha-2b and ribavirin for 48 weeks. Liver biopsies, scored by a single pathologist using the Histology Activity Index (HAI, range 0–18) and Ishak fibrosis scores (range 0–6), were performed before and after treatment. Gene expression profiles of PBMCs were performed using Affymetrix U133A gene chips. A total of 87% of SVR subjects and 88% of nonresponders (NR) had an HR, but no significant change in the liver fibrosis scores was observed (p> 0.05). For genotype 1 patients, a baseline fibrosis score ≤2 was related to a higher likelihood of SVR than those with a score >2 (p= 0.012). Combination therapy for HCV among HIV-coinfected subjects resulted in a modest SVR rate. Persons with mild liver disease had a better SVR rate, suggesting early treatment may be beneficial. Combination therapy resulted in an HR for most of the patients, however, further follow-up of these patients will determine the durability of such an HR.
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