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High rates of hepatitis C virus (HCV) cure using direct-acting antivirals in HIV/HCV-coinfected patients: a real-world perspective
- Source :
- The Journal of antimicrobial chemotherapy. 71(9)
- Publication Year :
- 2016
-
Abstract
- Objectives There are few data on the real-world experience of FDA-approved oral hepatitis C virus (HCV) direct-acting antiviral (DAA) drug combinations in HIV/HCV-coinfected patients. We evaluated the safety and efficacy of DAA therapies in a cohort of HIV/HCV patients in a large urban clinic in Chicago. Methods HIV/HCV-coinfected adults (≥18 years) enrolled in the Northwestern University Viral Hepatitis Registry between January 2013 and June 2015 were analysed. Treated patients received one of the following DAA combinations: sofosbuvir/ledipasvir, sofosbuvir/ribavirin, sofosbuvir/simeprevir or paritaprevir/ritonavir/ombitasvir/dasabuvir ± ribavirin. The primary outcome was sustained virological response at 12 weeks after DAA completion (SVR12). Results Seventy-seven HIV/HCV patients were evaluated for DAA therapy. Most patients were male (62/77, 81%) and infected with HCV genotype 1 (67/77, 87%). Some 32/77 (42%) were cirrhotic and 29/77 (38%) had received prior treatment with an IFN-containing regimen. DAA therapy was more likely to be started in Caucasians than persons of other ethnicities (P = 0.01). The overall SVR12 rate was 92% in 52 patients who completed therapy and had follow-up by the end of the study: sofosbuvir/simeprevir, 32/33 (97%); sofosbuvir/ribavirin, 4/7 (57%); sofosbuvir/ledipasvir, 11/11 (100%); and paritaprevir/ritonavir/ombitasvir/dasabuvir, 1/1 (100%). Four patients relapsed after therapy with sofosbuvir/simeprevir (n = 1) or sofosbuvir/ribavirin (n = 3). Adverse events were uncommon and did not result in DAA treatment interruption or discontinuation. Conclusions The HCV DAA combinations of sofosbuvir/ledipasvir and sofosbuvir/simeprevir were highly effective and well tolerated in this diverse population of HIV/HCV-coinfected patients, many of whom had advanced liver disease. HIV coinfection should not be considered a barrier to successful HCV treatment with DAAs.
- Subjects :
- Microbiology (medical)
Simeprevir
Ledipasvir
Adult
Male
medicine.medical_specialty
Sofosbuvir
Adolescent
Drug-Related Side Effects and Adverse Reactions
HIV Infections
Antiviral Agents
Cohort Studies
03 medical and health sciences
chemistry.chemical_compound
Young Adult
0302 clinical medicine
Internal medicine
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Aged
Original Research
Pharmacology
Chicago
Dasabuvir
business.industry
Coinfection
virus diseases
Hepatitis C
Hepatitis C, Chronic
Middle Aged
medicine.disease
Virology
Ombitasvir
Infectious Diseases
Treatment Outcome
chemistry
Paritaprevir
030211 gastroenterology & hepatology
Ritonavir
Drug Therapy, Combination
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 14602091
- Volume :
- 71
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The Journal of antimicrobial chemotherapy
- Accession number :
- edsair.doi.dedup.....b2aedf253260baeab2f01848dc812cc0