Direct-Acting Antivirals Have Lower SVR Rates for HCV/HIV Coinfection

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The most common reported adverse effects were fatigue, anemia, and leucopenia.
The most common reported adverse effects were fatigue, anemia, and leucopenia.

Direct-acting antiviral (DAA) regimens result in lower rates of sustained virologic response at 12 weeks (SVR 12) for patients with hepatitis C virus (HCV)/HIV coinfection compared with HCV mono-infection, according to results published in Gut and Liver.

The results warrant further studies of participants with HCV/HIV coinfection to identify predictors of reduced response to DAAs.

The study included participants with HCV mono-infection or HCV/HIV coinfection who were treated with DAAs at a community clinic between January 2014 and October 2017 (N=327: 253 with HCV and 74 with HCV/HIV). All participants received at least 12 weeks of treatment with 1 of the recommended combination regiments in standard doses for chronic HCV infection. The researchers compared pretreatment baseline characteristics, treatment efficacy, factors affecting SVR 12 after treatment, and adverse reactions between the 2 groups.

Overall, 94% of participants with HCV mono-infection achieved SVR 12 compared with 84% with HCV/HIV coinfection (P =.005). This finding remained consistent even after adjusting for baseline characteristics.

Despite the significant difference in SVR 12 rates, the researchers were unable to identify any factors that significantly predicated lack of response to DAAs for participants with HCV/HIV.

The researchers did not find any significant drug interaction between DAAs and antiretroviral therapy. No participants discontinued treatment because of adverse events.

"Treatment in HCV/HIV co-infected group needs particular attention while choosing DAAs regimen and duration of treatment," the researchers wrote.

Reference

Gayam V, Hossain MR, Khalid M, et al. Real-world clinical efficacy and tolerability of direct-acting antivirals in hepatitis C monoinfection compared to hepatitis C/HIV coinfection in a community care setting [published online June 22, 2018]. Gut Liver. doi: 10.5009/gnl18004

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