New Hepatitis C Treatments Highly Effective for HIV/HCV Coinfected People

HIV and Hepatitis
Liz Highleyman
Original Article:

A pair of interferon-free combinations — AbbVie’s 3-drug Viekira Pak regimen and Gilead Science’s sofosbuvir/ledipasvir (Harvoni) — demonstrated good safety and cured more than 90% of genotype 1 HIV/HCV coinfected people, according to studies published in the February 23 advance edition of the Journal of the American Medical Association.

About one-third of people with HIV are coinfected with hepatitis C virus (HCV). Coinfected people experience more rapid liver disease progression and do not respond as well to interferon-based therapy, so traditionally were considered hard-to-treat. But with the advent of direct-acting antivirals (DAAs) that can be combined into interferon-free regimens, coinfected people have cure rates and side effects similar to those of HIV negative people.

Viekira Pak Regimen

As described in the first article, Mark Sulkowski and fellow investigators with the TURQUOISE-I trial evaluated AbbVie’s Viekira Pak or "3D" regimen, consisting of the HCV NS3/4A protease inhibitor paritaprevir, NS5A inhibitor ombitasvir, and a ritonavir booster in a once-daily coformulation, taken with the twice-daily non-nucleoside HCV NS5B polymerase inhibitor dasabuvir.

This open-label trial included 63 coinfected patients in the U.S. and Puerto Rico with HCV genotype 1. Most were men, three-quarters were white, and the average age was 51 years. Two-thirds were treatment-naive while one-third had previously undergone interferon-based therapy (6% prior relapsers, 11% partial responders, and 16% null responders). More than 90% had harder-to-treat HCV subtype 1a, with a minority having 1b. More than half had absent to mild liver fibrosis, but nearly one-fifth had cirrhosis.

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