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Virological response rates for telaprevir‐based hepatitis C triple therapy in patients with and without HIV coinfection
Author(s) -
MartelLaferrière V,
Brinkley S,
Bichoupan K,
Posner S,
Stivala A,
Perumalswami P,
Schiano TD,
Sulkowski M,
Dieterich DT,
Branch AD
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12086
Subject(s) - medicine , ribavirin , coinfection , gastroenterology , telaprevir , hepatitis c , hepatitis c virus , pegylated interferon , odds ratio , viral load , rash , human immunodeficiency virus (hiv) , immunology , virus
Objectives Pegylated‐interferon/ribavirin dual therapy for hepatitis C virus ( HCV ) infection has a lower sustained virological response ( SVR ) rate in HIV / HCV ‐coinfected patients than in HCV monoinfected patients, but little is known about the relative effectiveness of teleprevir‐based triple therapy in the two groups. Methods Data on 33 coinfected and 116 monoinfected patients were analysed on an intention‐to‐treat basis. SVR12 was defined as undetectable HCV RNA at week 12 post‐end‐of‐treatment, severe anaemia as haemoglobin ≤ 89 g/L or a drop of ≥ 45 g/L, and advanced fibrosis/cirrhosis as F ib‐4 ≥ 3.25. All coinfected patients had well controlled HIV infection. Results The groups were similar in age, gender, percentage with Fib‐4 ≥ 3.25 and HCV viral load, but differed in previous treatment response, with more coinfected patients being nonresponders or treatment‐intolerant (75.8% vs. 50.0% for monoinfected patients; P < 0.01). During treatment, the percentages of patients with undetectable HCV RNA were similar, but, surprisingly, this percentage tended to be higher in coinfected patients. SVR12 rates were 60.6% in coinfected patients vs. 42.2% in monoinfected patients ( P = 0.06). In multivariable analysis, SVR12 was associated with HIV infection [odds ratio ( OR ) 3.55; P < 0.01], A frican A merican race ( OR 0.37; P = 0.03) and previous treatment response ( OR 0.46; P = 0.03). Rates of severe anaemia (45.5 vs. 58.6% in coinfected and monoinfected patients, respectively; P = 0.18) were similar in the two groups, but rash (15.2 vs. 34.5%, respectively; P = 0.03) and rectal symptoms (12.1 vs. 43.1%, respectively; P < 0.01) were less common in coinfected patients. Conclusions Virological responses of coinfected and monoinfected patients did not differ significantly, but tended to be higher in coinfected patients, who had a 60.6% SVR12 rate. Telaprevir‐based triple therapy is a promising option for coinfected patients with well‐controlled HIV infection.