Two interferon-free regimens show high HCV cure rates for people with HIV and HCV co-infection

Liz Highleyman
Original Article: 

A pair of two-drug, 12-week regimens containing neither interferon nor ribavirin – sofosbuvir (Sovaldi) plus either ledipasvir (the Harvoni coformulation) or daclatasvir (Daklinza) – cured hepatitis C for more than 95% of people with HIV and hepatitis C co-infection, according to two presentations at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) this week in Seattle, USA. These findings confirm that people living with HIV who have hepatitis C can be treated the same as those with hepatitis C alone.

The advent of oral direct-acting antiviral agents (DAAs) that target different steps of the hepatitis C virus (HCV) lifecycle have revolutionised treatment, offering therapy that is shorter, better tolerated, and more effective than interferon-based therapy. This is particularly beneficial for people with HIV and HCV co-infection who tend to have more rapid liver disease progression and do not respond as well to interferon.


Susanna Naggie from Duke Clinical Research Center in North Carolina presented results from ION-4, a phase 3 trial evaluating the safety and efficacy of Gilead Science’s nucleotide HCV NS5B polymerase inhibitor sofosbuvir plus NS5A inhibitor ledipasvir in people with HIV and HCV co-infection.

Results from ION-1 (genotype 1 treatment-naive, 12 vs 24 weeks), ION-2 (genotype 1 prior non-responders, 12 vs 24 weeks) and ION-3 (genotype 1 treatment naive, 8 vs 12 weeks) were presented previously, showing that sofosbuvir/ledipasvir cured 95% or more of people with HCV mono-infection.

This study enrolled 335 participants with HIV and HCV co-infection in the USA, Canada and New Zealand. The trial had broad inclusion criteria and included more difficult-to-treat groups such as prior non-responders and people with liver cirrhosis.

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