Hepatitis C, HIV coinfection treatment yields high sustained virologic response rates
The high sustained virologic response rates in these studies suggest that future barriers to unnecessary HCV-related deaths may be related to health-care system failures.
Hep C, HIV coinfection treatment yields high SVR rates
HealthDay News — For patients with hepatitis C virus genotype 1 and HIV coinfection, new regimens are effective and correlate with high rates of sustained virologic response after treatment, according to two studies published in the Journal of the American Medical Association.
“Patients co-infected with HIV and hepatitis C virus (HCV) are at high risk for liver disease progression. However, interferon-based treatments for HCV infection have significant toxicities, limiting treatment uptake,” noted Mark S. Sulkowski, MD, of Johns Hopkins University in Baltimore, and colleagues.
To assess the all-oral three direct-acting antiviral (3D) regiment of ombitasvir, paritaprevir (co-dosed with ritonavir [paritaprevir/r]), dasabuvir, and ribavirin in HCV genotype 1-infected adults with HIV-1 co-infection -- including patients with cirrhosis — the investigators conducted a randomized, open-label study. The patients (n=63) all had HCV genotype 1 and HIV-1 coinfection and received the all-oral 3 direct-acting antiviral (3D) regimen of ombitasvir, paritaprevir (co-dosed with ritonavir), dasabuvir, and ribavirin for 12 or 24 weeks.
In 94% and 91% percent, respectively, patients receiving 12 or 24 weeks of 3D and ribavirin achieved sustained virologic response (SVR) at post-treatment week 12 (SVR12). Fatigue, insomnia, nausea, and headache were the most common treatment-emergent adverse events, reported the scientists.
In a separate study, Anu Osinusi, MD, MPH, of the University of Maryland in Baltimore, and colleagues examined the rates of SVR and adverse events in 50 previously untreated patients with HCV genotype 1 and HIV co-infection following a 12-week treatment with ledipasvir (90 mg) and sofosbuvir (400 mg).
Of the patients, 98% achieved SVR12 and one patient experienced a relapse at four weeks post-treatment. The most common adverse events included nasal congestion and myalgia (16 and 14 percent, respectively).
"The high SVR rates in these two studies suggest that future barriers to prevention of unnecessary deaths due to HCV may be related to failures of the health care system," wrote Camilla S. Graham, MD, MPH, of Beth Israel Deaconess Medical Center, in Boston, in an accompanying editorial.