A model to predict the response to therapy against hepatitis C virus (HCV) including low-density lipoprotein receptor genotype in HIV/HCV-coinfected patients

J Antimicrob Chemother. 2013 Apr;68(4):915-21. doi: 10.1093/jac/dks488. Epub 2012 Dec 12.

Abstract

Objectives: Accurate prediction of sustained virological response (SVR) to pegylated interferon-α (Peg-IFN) plus ribavirin in HIV/hepatitis C virus (HCV)-coinfected patients could improve the management of these patients. We aimed to develop a model to predict SVR to Peg-IFN/ribavirin in HIV/HCV-coinfected individuals combining HCV genotype and baseline HCV RNA load with interleukin 28B and low-density lipoprotein receptor genetic variations.

Methods: Three hundred and twelve treatment-naive HIV/HCV-coinfected patients receiving Peg-IFN/ribavirin were analysed in an on-treatment approach. One hundred and eighty-one of them were included in the development group and 131 in the validation population. The predictive model was obtained from a logistic regression equation including the above-mentioned variables. The areas under the receiver operating characteristic (AUROC) curves (95% CI), sensitivity and specificity, as well as negative and positive predictive values, were calculated.

Results: SVR was achieved by 88 (48.6%) patients from the development group and 68 (51.9%) individuals from the validation group. The AUROC curve values (95% asymptotic CI) were 0.83 (0.77-0.89) for the development group and 0.84 (0.77-0.91) for the validation group. Using two cut-off values, maximum specificity and sensitivity were 89.7% and 96.6%, respectively, with a negative predictive value for SVR of 88.9% and a positive predictive value of 83.6%. Thirteen (7.2%) individuals were misclassified using these cut-off values.

Conclusions: This model represents a reliable and easily applicable tool to individually evaluate the probability of achieving an SVR to Peg-IFN/ribavirin among HIV/HCV-coinfected patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage*
  • Female
  • Genotype
  • HIV Infections / complications*
  • Hepacivirus / classification
  • Hepacivirus / drug effects
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon-alpha / administration & dosage
  • Male
  • Middle Aged
  • Models, Statistical
  • Prognosis
  • Prospective Studies
  • Ribavirin / administration & dosage
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Ribavirin