Background The development of direct acting antiviral agents (DAAs) represents a significant improvement in hepatitis C virus (HCV) treatment, particularly in allowing interferon free therapy. HIV coinfection is common, with genotypes 1 and 4 being the most prevalent. It is important to decide which treatment is best in coinfected patients.
Purpose To evaluate the effectiveness and safety of treatment with different combinations of DAAs in HIV/HCV coinfected patients.
Material and methods A retrospective observational study was conducted of coinfected patients who initiated therapy with DAAs from April 2015 to March 2016. We included only patients with HCV genotype 4. Data were collected from electronic clinical history, electronic prescribing software and drug therapy follow-up. Variables included: sex, liver fibrosis stage, type of patient (pretreated/treatment naive), treatment duration, and RNA viral levels before starting treatment and at 4 and 12 weeks. We considered that the drug was effective if the patient achieved SVR12, which was defined as undetectable RNA viral level 12 weeks after treatment completion.
Results 11 patients (2 women, 9 men) started treatment with sofosbuvir/ledipasvir (SOF/LDP). 7 were treatment naïve and 4 had been pretreated. Hepatic fibrosis stage F4/F3/F2 corresponded to 3, 5, 3 patients, respectively. Duration of treatment was 12 weeks. 81.8% of patients achieved an undetectable viral load after 4 weeks, maintained after 12 weeks in all cases but SVR12 was achieved in 10 patients. No patient discontinued treatment for adverse events although 6 patients experienced adverse effects: asthenia (2), headache (4) and insomnia (1).
14 patients (3 women, 11 men) were treated with ombitasvir/paritaprevir/ritonavir (OTV/PTV/r) plus ribavirin (RBV). 9 were treatment naïve patients. For hepatic fibrosis stage: 1 patient was F4, 6 F3 and 7 F2. Duration of treatment was 12 weeks. 57.1% of patients achieved an undetectable viral load after 4 weeks, 100% after 12 weeks and SVR12 was achieved in all patients. Regarding safety, 8 patients reported some adverse events (most frequent was pruritus) and 1 of these discontinued treatment because of pruritus, anaemia, diarrhoea and vomiting before 4 weeks.
Conclusion 90.9% of patients treated with SOF/LDP achieved SVR12 and 100% of patients treated with OTV/PTV/r plus RBV. The adverse effects profile indicated both combinations appeared safe and well tolerated in general.
No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.