Baseline serum low-density lipoprotein cholesterol levels predict response to hepatitis C virus therapy in HIV/hepatitis C virus coinfected patients

• Published in: AIDS (London) Vol. 22; no. 8; pp. 923 - 930
• Main Authors: DEL VALLE, José, MIRA, José A, GARCIA-GARCIA, José A, PINEDA, Juan A, DELOS SANTOS, Ignacio, LOPEZ-CORTES, Luis F, MERINO, Dolores, RIVERO, Antonio, GIRON, José A, RIOS-VILLEGAS, Maria J, GONZALEZ-SERRANO, Mercedes, COLLADO, Antonio
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 11-05-2008
• Subjects: Adult; AIDS/HIV; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - therapeutic use; Biological and medical sciences; Biomarkers - blood; Cholesterol, LDL - blood; Drug Therapy, Combination; Female; Hepacivirus - isolation & purification; Hepatitis C virus; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - virology; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Interferon-alpha - therapeutic use; Lipids - blood; Male; Medical sciences; Pharmacology. Drug treatments; Polyethylene Glycols - therapeutic use; Recombinant Proteins; Retrospective Studies; Ribavirin - therapeutic use; RNA, Viral - blood; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Antiretroviral agent; Mixed infection; antiretroviral therapy; Hepatic disease; pegylated interferon; Lipoprotein; Antiviral; Serum; Pegylated form; lipoproteins; Viral hepatitis C; Immunopathology; Cytokine; Cholesterol LDL; AIDS; Immune deficiency; Infection; Virus; Chemotherapy; Treatment; Viral disease; Digestive diseases; Interferon; Flaviviridae; Predictive factor; Hepatitis C virus; Hepacivirus
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0b013e3282ff8ad3

High levels of serum low-density lipoprotein cholesterol are associated with better response to pegylated interferon and ribavirin in hepatitis C virus monoinfected patients. There are no data concerning this topic in HIV/hepatitis C virus coinfected patients in whom lipid disorders are particularly common.
To assess the association between baseline lipid levels and sustained virologic response to pegylated interferon and ribavirin in coinfected patients.
A total of 260 HIV/hepatitis C virus coinfected patients under treatment with pegylated interferon and ribavirin and who had a baseline serum lipid profile were included in this retrospective study.
Thirty-eight (24%) patients with genotypes 1-4 and 64 (63%) with genotypes 2-3 achieved sustained virologic response. Forty-nine (44%) patients with serum low-density lipoprotein cholesterol levels 100 mg/dl or more showed sustained virologic response compared with 53 (36%) with lower values [adjusted odds ratio: 2.51; 95% confidence interval: 1.40-4.87; P = 0.003]. This association was independent of the remaining predictors of sustained virologic response which were genotypes 2-3, plasma hepatitis C virus RNA 600,000 IU/ml or less, exposure to at least 80% of the planned therapy and lack of concomitant antiretroviral therapy. The rate of sustained virologic response in patients with genotype 1 and low-density lipoprotein cholesterol at least 100 mg/ml was 31% compared with 17% in those with lower values (adjusted odds ratio: 2.19; 95% confidence interval: 1.04-4.66; P = 0.040). The corresponding figures in subjects with genotypes 2-3 were 73 and 58% [2.71 (0.99-7.46); P = 0.054]. No other lipid was associated with response.
Higher low-density lipoprotein cholesterol levels predict sustained virologic response to pegylated interferon and ribavirin in HIV/hepatitis C virus coinfected patients. This might be used to improve the rate of sustained virologic response in this setting.