Does HIV Coinfection Influence HCV Treatment Duration?

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Treatment response was similar in HCV monoinfections and HCV/HIV coinfections.
Treatment response was similar in HCV monoinfections and HCV/HIV coinfections.

Data published in HIV Medicine supports recent European Association for the Study of the Liver treatment guidelines suggesting there is no longer a need to differentiate between hepatitis C (HCV) monoinfection and HCV/HIV coinfection when treating these patients.

Investigators from Germany used data from the Deutsches Hepatitis C-Registry to determine cure rates in patients infected with HCV or co-infected with HCV and HIV (n=5657 and 488, respectively). For both groups, study investigators assessed rates of sustained virologic response 12 weeks after the scheduled end of therapy.

Patients with HCV/HIV coinfection (n=488) were 84.6% male and were often younger than those with HCV monoinfection (46.5±9 years). CD4 cell count was greater than 250 cells/μL in 63.1% and 88.7% of patients with monoinfection and coinfection, respectively.

The 12-week sustained virologic response rate was 90.3% in the patients with HCV monoinfection and 91.2% in patients with HCV/HIV coinfection. In addition, liver cirrhosis was confirmed in 29.5% and 17.2% of people with mono- and coinfections, respectively (P <.001). Shortened treatment duration of 8 weeks did not result in a reduction of patients with sustained virologic response at 12 weeks (93.7%).

"We found high [sustained virologic response at 12 weeks] rates in mono-infected as well as co-infected individuals," the researchers concluded. "No differences were detected between the two subgroups regardless of whether there was accompanying cirrhosis or shortened treatment duration."

These findings support current treatment guidelines that do not differentiate HCV monoinfection from HIV/HCV coinfection.

Reference

Bischoff J, Mauss S, Cordes C, et al. Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy? [published online January 25, 2018]. HIV Med. doi: 10.1111/hiv.12579

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