Effectiveness of Ledipasvir/Sofosbuvir for Acute HCV Infection in HIV

antiviral treatment, HIV
antiviral treatment, HIV
Study evaluated the optimal duration of ledipasvir/sofosbuvir for the treatment of acute hepatitis C virus (HCV) infection in HIV.

An 8-week regimen of ledipasvir plus sofosbuvir treatment for acute hepatitis C in HIV-infected individuals resulted in a 100% sustained virologic response rate, according to the results of a study reported at the 2017 American Association for the Study of Liver Diseases meeting.

In the SWIFT-C multicenter clinical trial, the efficacy and safety of ledipasvir plus sofosbuvir were evaluated in 27 patients with hepatitis C and HIV co-infection (median age 46 years; 100% male; 33% Hispanic; 81% never used intravenous drugs). Patients had acute hepatitis C infection diagnosed within 24 weeks of study enrollment, and genotypes 1 (96% of patients) and 4 (4%) were included.

At baseline, median hepatitis C RNA was 1,490,000 IU/mL, and 22% of patients had a high baseline RNA (>6 million IU/mL). All patients were receiving antiretroviral agents, and HIV-1 RNA level was below the lower limit of quantitation.

All patients completed the 8 weeks of ledipasvir and sofosbuvir. At 12 weeks posttreatment, the sustained virologic response (SVR) rate was 100% (90% CI, 90%-100%). According to the study authors, the SVR rate was superior to the historical rate of 60% achieved with pegylated interferon and ribavirin.

Grade 2 or higher adverse events occurred in 37% of participants. No adverse events related to nephrotoxicity were reported, and no events related to renal toxicity were reported for patients receiving the antiretroviral tenofovir.

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The study authors concluded that, “these data support an 8-week duration of [ledipasvir plus sofosbuvir] in the treatment of acute HCV infection in HIV-infected persons.”


Naggie S, Fierer DS, Hughes M, et al. 100% SVR with 8 weeks of ledipasvir/sofosbuvir in HIV-infected men with acute HCV infection: results from the SWIFT-C trial (sofosbuvir-containing regimens without interferon for treatment of acute HCV in HIV-1 infected individuals). [AASLD abstract 196].  Hepatology. 2017;66:1-148. doi:10.1002/hep.29500