Treatment with the direct-acting antiviral Zepatier for 8 weeks showed high efficacy among HIV-positive men who have sex with men infected with acute hepatitis C, according to study results presented at the Conference on Retroviruses and Opportunistic Infections, also known as CROI.
“In the Netherlands, the group with the highest number of acute hepatitis C infections are men who have sex with men,” Anne Boerekamps, MD, from the Erasmus University Medical Center, the Netherlands, said her in her presentation. “DAA labels only talk about chronic hepatitis C, and this resulted in reimbursement restrictions in many countries for the treatment of acute hepatitis C with DAAs. Therefore, we feel that convincing evidence is needed to support the cost-effectiveness and efficacy of DAA therapy for acute hepatitis C.”
Boerekamps and colleagues enrolled 68 MSM patients with HIV and acute HCV genotype 1 or 4 in a prospective multicenter trial. Patients received 8 weeks of Zepatier (elbasvir/grazoprevir, Merck). Five patients did not initiate treatment.
Regarding intention-to-treat, 62 of 63 patients who initiated therapy achieved sustained virologic response (98%; 95% CI, 91-100). SVR remained high at 94% (95% CI, 85-98), including three patients who became reinfected.
One patient relapsed without new NS5A or NS3 resistance-associated substitutions compared with baseline and one patient who achieved SVR had a phylogenetically proven new infection.
The researchers observed no treatment-related serious adverse events and most adverse events were mild.
“We can say that 8 weeks of elbasvir/grazoprevir for acute hepatitis C was safe, highly effective and non-inferior compared to previous studies of chronic hepatitis C with a longer treatment duration,” Boerekamps concluded. – by Talitha Bennett
Reference: Boerekamps A, et al. Abstract 128. Presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2018; Boston.
Disclosure: Boerekamps reports no relevant financial disclosures.