Efficacy of Long-Acting Cabotegravir Plus Rilpivirine in Patients With HIV Coinfected With Asymptomatic Hepatitis C

The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.

Treatment with long-acting (LA) cabotegravir plus rilpivirine was found to be effective and well tolerated among a small cohort of participants with HIV coinfected with asymptomatic hepatitis c virus (HCV), according to research presented at IDWeek, held virtually from September 29 to October 3, 2021.

Using data from the phase 3b ATLAS-2M study (ClinicalTrials.gov identifier: NCT02951052), researchers compared the efficacy and safety of LA cabotegravir plus rilpivirine at week 48 between participants with HIV RNA viral loads of less than 50 copies/mL vs those with viral loads greater than or equal to 50 copies/mL. Exclusion criteria included treatment for symptomatic chronic HCV infection within the past 12 months.

Among a total of 1045 participants included in the study, 10 had HCV coinfection, 6 of whom were women. At week 48, 90% (9/10) of participants with HCV coinfection and 94% (972/1035) of those with HIV monoinfection had viral loads of less than 50 copies/mL (adjusted difference, 4.1; 95% CI, ˗14.5 to 22.6). Compared with participants with HIV monoinfection, none of those with HCV coinfection experienced virologic failure (0 vs 10) or had viral loads greater than or equal to 50 copies/mL (0 vs 14).

The researchers found that injection site reactions were the most frequently reported adverse event in participants HCV coinfection (n=5), of which all were grade 1 or 2 adverse events, and none led to study withdrawal. Of note, no participant with HCV coinfection experienced liver abnormalities. In addition, cabotegravir and rilpivirine plasma concentrations were found to be similar between participants with HCV coinfection vs those with HIV monoinfection.

Disclosure: All authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.

Reference

D’Amico R, Benn P, Thiagarajah S, et al. Efficacy and safety of long-acting cabotegravir + rilpivirine in participants with HIV/HCV co-infection: ATLAS-2M 48-week results. Presented at: IDWeek; September 29 to October 3, 2021. Poster 833.

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