Peters L, Cozzi-Lepri A, Hepatitis C Working Group for the Collaboration of Observational HIV Research Europe (COHERE) in EuroCoord

BACKGROUND Long-term clinical outcomes after HCV treatment of HIV/HCV patients are not well described. We aimed to compare the risk of all-cause and liver-related death according to HCV treatment response in HIV/HCV patients in the multi-cohort study COHERE.

METHODS All patients who had started PEG-interferon + ribavirin (baseline) and followed for ≥72 weeks after baseline were included. Patients were categorized into three response groups depending on treatment duration and HCV-RNA measured in the window 24-72 weeks after baseline. Patients who received ≥24 weeks of therapy were defined as responders if their last HCV-RNA measured between 24-72 weeks after baseline was negative, and having'unknown response'if HCV-RNA was unknown. Non-responders were treated for less than 24 weeks or were HCV-RNA+ between 24-72 weeks after baseline.Mortality rates were compared using survival analysis, and Cox regression used to compare hazard ratios of death between response groups.

RESULTS 3,755 patients were included: 1031 (27.5%) responders, 1,639 (43.6%) non-responders and 1085 (28.9%) with unknown response. Rates (per 1,000 PYFU, 95% CI) of all-cause death were 17.59 (14.88-20.78), 10.43 (7.62-14.28) and 11.00 (8.54-14.23) for non-responders, responders and unknown responders, respectively. After adjustment, the relative hazard (non-responders vs. responders) for all-cause death, liver-related death and non-liver-related death was 1.53 (95% CI 1.06-2.22), 3.39 (95% CI 1.32-8.75) and 1.22 (95% CI 0.80-1.84), respectively.

CONCLUSION HIV/HCV patients with a favourable virological response to PEG-interferon + ribavirin had reduced risk of all-cause and liver-related death, while there was no difference in risk of non-liver-related death when comparing responders and non-responders.

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