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United European Gastroenterol J. 2019 May;7(4):507-516. doi: 10.1177/2050640619835394. Epub 2019 Mar 6.

High efficacy of interferon-free therapy for acute hepatitis C in HIV-positive patients.

Author information

1
Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
2
Vienna HIV & Liver Study Group, Vienna, Austria.
3
Department of Internal Medicine IV, Wilhelminenspital, Wiener Krankenanstaltenverbund (KAV) der Stadt Wien, Vienna, Austria.
4
Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria.
5
Department of Internal Medicine and Gastroenterology, Klinikum Klagenfurt am W├Ârthersee, Klagenfurt, Austria.

Abstract

Background:

The treatment of acute hepatitis C (AHC) with direct-acting antiviral agents (DAAs) is considered a cornerstone of hepatitis C virus (HCV) elimination strategies, especially in human immunodeficiency virus (HIV)-infected individuals at high risk of onward transmission.

Objective:

Optimal treatment regimens and duration for AHC in HIV-coinfected patients remain to be established. Thus, we aimed to evaluate the efficacy and safety of DAA treatment regimens in the setting of AHC.

Methods:

All HIV-positive patients with a diagnosis of AHC according to the European AIDS Treatment Network (NEAT) consensus attending our clinic after 2014 were included. DAA treatment regimens and duration were based on current recommendations for chronic hepatitis C (CHC) at treatment initiation.

Results:

Thirty-eight HIV/AHC patients (median age 42.0 years), mostly men who have sex with men (92%), were started on interferon-free regimens. HCV-genotype (GT) was predominately GT-1a (65%). The following DAA regimens were prescribed: ombitasvir/paritaprevir/ritonavir/dasabuvir (42%; 16/38), glecaprevir/pibrentasvir (29%; 11/38), sofosbuvir/ledipasvir (13%; 5/38), ombitasvir/paritaprevir/ritonavir (5%; 2/38), grazoprevir/elbasvir (5%; 2/38) and sofosbuvir/velpatasvir (5%; 2/38). All HIV/AHC patients achieved sustained virologic response 12 weeks after end of treatment (SVR12) (100%; 38/38). DAA-related adverse events were rare.

Conclusion:

Interferon-free DAA regimens (including 34% pan-genotypic regimens) yielded 100% SVR12 in HIV/AHC individuals if treatment durations similar to CHC are applied.

KEYWORDS:

Hepatitis C virus; coinfection; human immunodeficiency virus; men who have sex with men

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