Response to DAA treatment in HCV/HIV coinfection varies
BARCELONA — In two late-breaking posters presented at the International Liver Congress 2016, researchers investigated HIV impact on response to direct-acting antiviral therapy among patients with hepatitis C virus infection/HIV co-infection, and found conflicting results.
“These differing data confirm that the study of HCV treatment in HIV co-infected patients remains an interesting and valuable subject for study,” Laurent Castera, MD, PhD, EASL secretary-general, said in a press release. “More research is needed to come to a viable resolution so we can provide the best care for these coinfected patients.”
In a prospective study of data from 1,276 patients with HCV/HIV co-infection at 33 hospitals in Spain, Karin Neukam, MD, of the unit of infectious diseases and microbiology, University Hospital of Valme, Spain, and colleagues found that HIV negatively impacted patient sustained virologic response rate to direct-acting antiviral (DAA) therapy.
Patients with HCV/HIV co-infection had an 11% lower rate of achieving SVR 12 weeks post-treatment on an interferon-based treatment regimen with DAAs compared to patients with HCV alone. In addition, patients with HCV/HIV coinfection on interferon-free regimens with DAAs had a 6% lower rate of SVR12.
“Our study demonstrates the impact of HIV co-infection on the effectiveness of DAA-based treatment. We must keep a close eye on co-infected patients to ensure that they receive the treatment they need,” Neukam said in a press release.
On the contrary, in a retrospective study using data of 408 patients with HCV, researchers, including Justin McGinnis, MD, of the University of Southern California, could not determine a significant, negative impact of HIV on SVR12.
SVR12 rates post-treatment were greater than 88% among patients with HCV (79% with genotype 1) treated with various antiviral regimens, including Olysio (simeprevir, Janssen), Sovaldi (sofosbuvir, Gilead Sciences), Harvoni (ledipasvir/sofosbuvir, Gilead Sciences) and Viekira Pak (ombitasvir, paritaprevir and ritonavir tablets with dasabuvir tablets, AbbVie). Researchers performed a logistic regression analysis to control for patient, demographics, disease severity and comorbidities. In this analysis, HIV did not significantly impact achievement of SVR.
“Our analysis showed that across three treatments in our study, there was no statistically significant impact of HIV co-infection on the effectiveness of the DAAs. We know that these patients are at increased risk of liver disease progression form their HCV status, and these data suggest the coinfected patient group could benefit from treatment,” McGinnis said in the release. – by Melinda Stevens
Neukam K, et al. Abstract LBP513. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.
McGinnis J, et al. Abstract LBP514. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.
Disclosure: Neukam reports receiving lecture fees from Bristol-Myers Squibb, Janssen-Cilag, Roche and Merck Sharp & Dohme; research support from Abbott Pharmaceuticals, Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag and Merck Sharp & Dohme. McGinnis reports the study was funded by AbbVie.