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The Effects of Interferon/Ribavirin Therapy on Bone Turnover Markers (BTMs) in HIV/HCV Co-Infected Subjects
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from Jules: AS I would expect the simple explanation of the outcome of this study is that it suggests achieving an SVR improves bone health, and having cirrhosis likely is associated with worsening bone health, I think the longer one has HCV the worse bone health gets in HCV mono and coinfection, so although this gets no attention bone health is an extra-hepatic manifestation of HCV & curing HCV probably addresses this situation, either erases the issue or improves bone outcomes. Now this study was from an old ACTG study that looked at Peg/Rbv so the question is will an SVR with the new INF-free oral HCV drug regimens have the same affect of improving bone health, I think so but interferon itself had beneficial immunomodulatory affects so this is something worth researching. As well there is a similar question about HCC/liver cancer, old studies of Peg/Rbv found SVR improved risk for HCC so we need to establish that the new interferon-free HCV regimens will also improve the risk for developing HCC, I think they will but a study is in order.
Reported by Jules Levin
ICAAC 2014 Sept 5-9 Wash DC
A Substudy of ACTG A5178
R. Bedimo, M. Kang, P. Tebas, E. Overton, K. Hollabaugh, G. McComsey, D. Bhattacharya, C. Evans, T. Brown, B. Taiwo
In the nonparametric univariate analyses of baseline CTX, race, categorized prior TDF exposure, and cirrhosis were statistically significant (p≤0.05); subjects of non-White race, those with ≤ 48 weeks of prior TDF exposure (including those with no prior TDF experience) and cirrhotics had lower baseline CTX. Additionally, there was some evidence that lower age (<50 years) may be associated with lower CTX, but this was not statistically significant (p=0.098). These associations were assessed further in a multivariate regression model using log10-transformed baseline CTX values.
In the multivariate model, only cirrhosis remained statistically significant (p=0.0086) for CTX; cirrhotics had lower baseline CTX even after accounting for age, race, and prior TDF exposure
Therefore, the Whites had greater median decreases, and there was a similar numerical trend of greater decrease in the EVRs compared to non-EVRs, regardless of race. However, none of these trends described were statistically significant.
The cirrhotics had smaller median decreases, albeit the number of cirrhotics was small (total of 26), and there was a similar trend of greater decreases in EVRs compared to non-EVRs, regardless of cirrhosis status
The p-value in the comparison test between EVRs and non-EVRs became less significant after adjusting for race (p=0.22) or cirrhosis status (p=0.232)
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