CROI 2015: Highlights of Viral Hepatitis Therapy

High cure rates with all-oral regimens for patients with HIV/hepatitis C virus (HCV) coinfection were a highlight of the 2015 Conference on Retroviruses and Opportunistic Infections. Twelve weeks of sofosbuvir and daclatasvir led to sustained virologic response (SVR) rates of 96% in treatment-naive and 98% in treatment-experienced HCV genotype 1-infected patients. Twelve weeks of sofosbuvir plus ledipasvir had similar results, with SVR rates of 95% in treatment-naive and 96% in treatment-experienced patients. Patients with cirrhosis were included in both trials and attained SVR rates of 92% to 94%. Real-world performance of sofosbuvir and simeprevir resulted in SVR rates similar to those attained in clinical trials. Identifying HCV infection, linking patients to care, reducing barriers to drug access, and ensuring adherence will be key to realizing the enormous potential of high cure rates with interferon alfa-free therapies. Preventing reinfection after cure will be of particular importance in the HIV-infected population, which was highly impacted by reinfection rates of more than 20% during 5 years of follow-up in a meta-analysis.