NEW YORK — Most patients coinfected with HIV and hepatitis C virus infection at a clinic in Spain were considered “difficult to cure” primarily because of their HCV genotype and other factors, according to data presented at the AASLD/EASL Special Conference on Hepatitis C.
Researchers performed a retrospective analysis of HIV-positive patients (n=715) undergoing antiretroviral therapy at a clinic in Madrid to determine the profile of such patients and their course of treatment. Among the patients with HIV, 161 were coinfected with HCV, having tested positive for serum HCV-RNA twice during a period of more than 6 months.
More than half of the coinfected patients were naive to HCV therapy (52.2%), while 44.7% had received therapy with pegylated interferon plus ribavirin (97.2%) or triple therapy with boceprevir and telaprevir (5.5%). Thirty percent of treated patients had achieved sustained virologic response. Researchers said alcohol abuse, neuropsychiatric disorders and decompensated cirrhosis were the primary reasons untreated patients did not undergo HCV therapy.
Investigators determined that 133 HIV-HCV coinfected patients (median age, 51 years; 78.9% male) were candidates for direct-acting antivirals (DAA), and 63.8% had HCV genotype 1a. In addition to all patients undergoing ART, 47% were receiving non-nucleoside reverse transcriptase inhibitor-based therapy, 46% were receiving protease inhibitor-based therapy, and 7% were receiving a combination regimen.
“The current profile of HIV-HCV coinfected patients is dominated by particularly difficult-to-cure individuals with new DAA, such as those infected with unfavorable HCV genotypes (1a, 3 and 4), advanced liver fibrosis (49%) and prior peginterferon failure (38%),” the researchers wrote. “By contrast, HIV status seems to be controlled in most coinfected individuals.”
For more information:
Benítez-Gutiérrez L. Abstract #65. Presented at: AASLD/EASL Special Conference on Hepatitis C, Sept. 12-13, 2014; New York.
Disclosure: The researchers report no relevant financial disclosures.