Progress in eradication of HCV in HIV positive patients with significant liver fibrosis in ViennaReportar como inadecuado

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Wiener klinische Wochenschrift

pp 1–10

First Online: 27 January 2017Received: 18 August 2016Accepted: 19 December 2016DOI: 10.1007-s00508-016-1162-y

Cite this article as: Steiner, S., Bucsics, T., Schwabl, P. et al. Wien Klin Wochenschr 2017. doi:10.1007-s00508-016-1162-y Summary

AimWe aimed to investigate the efficacy of interferon and ribavirin-free sofosbuvir-ledipasvir SOF-LDV and ritonavir boosted paritaprevir-ombitasvir with or without dasabuvir 2D-3D regimens in a real-life cohort of human immunodeficiency virus-hepatitis C virus HIV-HCV coinfected patients. The study focused on efficacy, need for changes in antiretroviral therapy ART due to drug-drug interaction DDI, and treatment-associated changes in liver stiffness.

MethodsIn this study 36 patients n = 21 SOF-LDV and n = 15 2D-3D were retrospectively analyzed. Depending on the genotype the following treatment regimens were used: HCV genotype GT-1: either SOF-LDV or 3D, no patient with HCV-GT2 was included, HCV-GT3: SOF-LDV, HCV-GT4: 2D.

ResultsApproximately one third 35.3% of patients were treatment-experienced and 13.9% had cirrhosis. Antiretroviral therapy had to be changed in 38.1% of SOF-LDV and 60% of 2D-3D patients prior to anti-HCV treatment due to expected DDIs. We observed sustained virologic response SVR rates of 100% in patients treated with SOF-LDV 19-19 and 2D-3D 14-14. One 2D-3D patient was lost to follow-up, while two SOF-LDV patients died during therapy from non-treatment-related causes. They were excluded from the analysis. Between baseline and follow-up liver stiffness decreased from 11.4 to 8.3 kPa p = 0.008 and from 8.1 to 5.7 kPa p = 0.001 in SOF-LDV and 2D-3D patients, respectively.

ConclusionsWe confirmed the excellent HCV eradication rates >95% in a real-life cohort of HIV-HCV coinfected patients treated with SOF-LDV and 2D-3D. We observed no HCV relapse or breakthrough. More patients treated with 2D-3D required a change in ART than patients treated with SOF-LDV. Additionally, HCV eradication led to a rapid decline in liver stiffness.

KeywordsHIV Hepatitis C virus Sofosbuvir Ledipasvir 3D 

Autor: Sebastian Steiner - Theresa Bucsics - Philipp Schwabl - Mattias Mandorfer - Bernhard Scheiner - Maximilian Christopher Aich


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