Drugs boost virologic response for Hepatitis C patients with HIV

A combination of medications effectively produced a sustained virologic response (SVR) in hepatitis C virus (HCV) patients also infected with HIV, according to 2 studies.

Published in the March 24/21 issue of JAMA, the first study was led by Mark S. Sulkowski, MD, with Johns Hopkins University in Baltimore, Md., and the second study was led by Anu Osinusi, MD, MPH, with the Division of Infectious Diseases, Institute of Human Virology at the University of Maryland, Baltimore. 

Patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are at high risk for liver disease progression, researchers noted in the first study. “However, interferon-based treatments for HCV infection have significant toxicities, limiting treatment uptake,” Dr Sulkowski wrote.

As a result, researchers assessed the all-oral 3 direct-acting antiviral (3D) regimen 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. Among patients receiving 12 or 24 weeks of 3D and ribavirin, SVR12 was achieved by 29 of 31 patients and 29 of 32 patients, respectively.

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“…Treatment with the all-oral, interferon-free 3D-plus-ribavirin regimen resulted in high SVR rates among patients co-infected with HCV genotype 1 and HIV-1, whether treated for 12 or 24 weeks. Further phase 3 studies of this regimen are warranted in patients with co-infection,” Dr Sulkowski wrote.

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In the second study, 50 patients with HCV genotype 1 never before treated for HCV were prescribed a fixed-dose combination of ledipasvir (90 mg) and sofosbuvir (400 mg) once daily for 12 weeks. Importantly, 49 of the 50 participants achieved SVR 12 weeks after the end of treatment, and one patient experienced relapse at week four following treatment.

“….Administration of an oral combination of ledipasvir and sofosbuvir for 12 weeks was associated with high rates of SVR after treatment completion,” Dr Osinusi wrote. “Larger studies that also include patients with cirrhosis and lower CD4 T-cell counts are required to understand if the results of this study generalize to all patients co-infected with HCV and HIV.”

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