Patients with HIV/HCV may require ART switch to receive Olysio
In a cohort of patients coinfected with HIV and hepatitis C virus, a majority were required to undergo an antiretroviral therapy switch before beginning treatment with Olysio, according to data from a poster presentation at CROI 2015.
“These findings are significant to real-world clinical practice settings and highlight the complexity of using interferon-free [direct-acting antivirals] in this population and add further stress to an already burdened HIV care delivery system,” the researchers wrote.
Researchers from the University of Pittsburgh and University of Maryland conducted a retrospective chart review at the University of Pittsburgh Medical Center’s HIV/AIDS Program between June and October 2014 using data from 133 patients coinfected with HIV/HCV. Of these patients, 71% were male, 86% had HCV genotype 1 and 94% were undergoing ART.
Overall, 38% of patients were assigned a ritonavir-boosted regimen, 34% Sustiva (efavirenz, Bristol-Myers Squibb), 11% Isentress (raltegravir, Merck), 6% Edurant (rilpivirine, Janssen), 4% Tivicay (dolutegravir, ViiV Healthcare) and 1% elvitegravir/cobicistat (Gilead Sciences), according to the abstract.
Seventy-seven percent of patients (103/133) required an ART switch before being treated with Olysio (simeprevir, Janssen Therapeutics). Of these patients, a straightforward substitution was an option in 47 patients, another 40 patients were considered for a switch only after opinion from an HIV expert, and a switch was impossible for 16 patients as a result of HIV drug resistance mutations.
More than 30% of patients on a protease inhibitor could not undergo an ART switch.
“The majority of HIV/HCV coinfected patients will require ART switch prior to use of [simeprevir],” the researchers concluded. “Additionally, for nearly a third of patients on a [protease inhibitor], an ART switch may not be feasible.”
Cope R, et al. Poster 651. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.
Disclosure: Relevant financial disclosures were unavailable.