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Direct‐acting antivirals in hepatitis C virus ( HCV )‐infected and HCV / HIV ‐coinfected patients: real‐life safety and efficacy
Author(s) -
Milazzo L,
Lai A,
Calvi E,
Ronzi P,
Micheli V,
Binda F,
Ridolfo AL,
Gervasoni C,
Galli M,
Antinori S,
Sollima S
Publication year - 2017
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.12429
Subject(s) - medicine , ombitasvir , sofosbuvir , paritaprevir , dasabuvir , ritonavir , ledipasvir , ribavirin , daclatasvir , simeprevir , hepatitis c virus , hepatitis c , coinfection , gastroenterology , pegylated interferon , virology , viral load , virus , antiretroviral therapy
Objectives Clinical trials of all‐oral direct‐acting antivirals ( DAA s) for chronic hepatitis C virus ( HCV ) infection reported high response rates in HCV / HIV coinfection, similar to those obtained in HCV monoinfection. We evaluated the safety and efficacy of these regimens in a clinical practice setting. Methods In this prospective observational study, all the HCV ‐monoinfected and HCV / HIV ‐coinfected patients undergoing HCV treatment with all‐oral DAA regimens in a routine clinical setting from December 2014 to December 2015 were included in the analysis. Sustained virological response 12 weeks after the end of therapy ( SVR 12) and reported adverse events ( AE s) were evaluated. Resistance‐associated variants ( RAV s) were analysed in a subgroup of patients at baseline and at the time of viral rebound in those with virological failure. Results One‐hundred and nine patients (51 HCV ‐infected and 58 HCV / HIV ‐coinfected) were enrolled in the study. Sixty per cent had cirrhosis and 52% were pegylated interferon and ribavirin (peg IFN / RBV )‐experienced. Thirty‐six per cent received ombitasvir + paritaprevir/ritonavir + dasabuvir, 25% sofosbuvir + daclatasvir, 16% sofosbuvir + simeprevir, 17% sofosbuvir + ribavirin and 6% sofosbuvir + ledipasvir; ribavirin was used in 57% of subjects. The SVR 12 rate was 91% and 96% in HIV ‐infected and uninfected patients, respectively ( P = 0.44). The 4‐week HCV viral decline was similar in the two groups. RAV s were found at baseline in 23 of 49 patients and did not affect SVR 12. No predictors of SVR 12 were identified in our cohort. Conclusions Treatment with all‐oral DAA combinations of patients infected with HCV and with HCV / HIV under real‐life conditions led to high and similar rates of SVR 12. Moreover, the historical factors associated with a sustained virological response to peg IFN / RBV were not predictive of the response to all‐oral DAA s.