Interferon-free regimen effective in HCV, HIV coinfection

Rates of sustained virologic response ranged from 70% to 90% among patients with HCV and HIV coinfection in the PHOTON-1 study.

Interferon-free regimen effective in HCV/HIV coinfection
Interferon-free regimen effective in HCV/HIV coinfection

The first interferon-free treatment regimen to be tested in patients with hepatitis C virus and HIV coinfection was associated with high sustained virologic response rates at 12 weeks and 24 weeks, findings from the PHOTON-1 study indicate.

Susanna Naggie, MD, MHS, of Duke Clinical Research Institute, presented final data from the study, which assessed sofosbuvir plus ribavirin in 223 patients HCV genotypes 1, 2 and 3, and HIV coinfection of varying treatment status, at the 2014 Conference on Retroviruses and Opportunistic Infections.

Overall, sustained virologic response at 12 weeks (SVR12) ranged from 70% to 90% depending on HCV genotype with SVR rates in most cases “exactly the same as mono-infected patients,” according to Naggie.

Study treatment consisted of 400 mg once-daily sofosbuvir plus 1,000 mg to 1,200 mg weight-based ribavirin for 24 weeks among 114 treatment-naïve patients with HCV genotype 1. HIV infection was well controlled in all patients; none had been previously treated for HCV.  

The researchers also assessed 68 treatment-naive and 41 treatment-experienced patients with HCV genotypes 2 and 3. Previously untreated patients received sofosbuvir and ribavirin for 12 weeks and prior non-responders were treated for 24 weeks.

Among treatment- naïve genotype 1 patients, 76% achieved SVR12. One person had detectable HCV again after completing treatment – giving a sustained-virologic response rate at week 24 (SVR24) of 75%.

The SVR12 and SVR24 rates were 88% (for both groups) among treatment-naive patients with HCV genotype 2. However, SVR12 and SVR24 rates decreased to 67% for treatment-naive patients with HCV genotype 3. 

Among previously treated patients SVR24 rates were  92% for genotype 2 and 94% for genotype 3. The most common adverse events included fatigue, insomnia, headache and nausea.

“Overall, this regimen was very well-tolerated and was dosed with multiple ARTs. It appeared safe with HIV viral breakthrough occurring in only one patient who reported nonadherence to their ART,” Naggie said.   

References

  1. Naggie S. Abstract #26. Presented at: 2014 CROI. March 3-6, 2014. Boston.

Disclosure: Naggie reports no disclosures.

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