For patients coinfected with chronic hepatitis C and HIV, treatment regimens containing sofosbuvir are effective but come with a significant risk for adverse effects, according to a meta-analysis published in Virology Journal.
The researchers included 7 studies (n=1167 coinfected patients) in their analysis. They included clinical trials, case-control studies, and prospective cohort studies that assessed the efficacy and safety of sofosbuvir-containing regimens in patients coinfected with hepatitis C and HIV. The researchers searched PubMed Medline, EMBASE, and Cochrane databases to find eligible studies.
Of the 1167 coinfected patients, the researchers found that 94% (95% CI, 92%-95%) had a sustained virologic response at 12 weeks. Treatment-naive patients had a higher rate of sustained virologic response at 12 weeks compared with patients who had been treated previously (P <.01).
Despite the high rate of efficacy of sofosbuvir-containing regimens, the researchers found that 79.6% (95% CI, 77.1%-82.1%) of patients treated with these regimens experienced adverse events, with 2.8% (95% CI, 1.4%-4.3%) experiencing severe adverse events. The most common adverse events were fatigue, insomnia, asthenia, headache, diarrhea, and nausea.
The researchers noted that patients treated with sofosbuvir combined with other direct-acting antivirals had a higher likelihood of sustained virologic response at 12 weeks and a reduced rate of adverse events compared with patients treated with sofosbuvir and ribavirin.
Li G, Zang K, Zhang G, Zhu D, Deng X. Efficacy and safety of sofosbuvir-containing regimens in patients co-infected with chronic hepatitis C virus and human immunodeficiency virus: a meta-analysis. Virol J. 2018;15(1):19.