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HIV Coinfection Predicts Failure of Ledipasvir/Sofosbuvir in Treatment-Naïve Noncirrhotic Patients With HCV Genotype

Juan Berenguer1,2, José Luis Calleja3,4,5,6, María Luisa Montes7,8

  • 1Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Open Forum Infectious Diseases
|May 30, 2019
PubMed

Insights

HIV infection predicts treatment failure in patients with chronic hepatitis C. This study found HIV-positive individuals had lower sustained viral response rates when treated with ledipasvir/sofosbuvir.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Virology

Background:

  • Direct-acting antiviral (DAA) efficacy is often assumed similar for hepatitis C virus (HCV)-monoinfected and HIV/HCV-coinfected patients.
  • Limited data exist on HIV's impact on DAA treatment failure due to small numbers in trials.

Purpose of the Study:

  • To compare treatment outcomes of ledipasvir/sofosbuvir (LDV/SOF) for HCV genotype 1 in treatment-naïve patients with and without HIV.
  • To identify predictors of treatment failure in HCV patients receiving DAAs.

Main Methods:

  • A prospective registry study compared outcomes for LDV/SOF in treatment-naïve, noncirrhotic patients with HCV G1.
  • Included 1358 patients: 1055 HCV-monoinfected and 303 HIV/HCV-coinfected (99% on antiretroviral therapy).

Main Results:

  • Sustained viral response (SVR) rates at 12 weeks were significantly lower for HIV/HCV-coinfected patients (91.8%) compared to HCV-monoinfected patients (97.2%; P = .001).
  • Multivariable analysis identified male sex (aOR, 2.49) and HIV infection (aOR, 2.23) as predictors of treatment failure.

Conclusions:

  • HIV infection is a significant predictor of treatment failure in patients receiving LDV/SOF for chronic hepatitis C.
  • Findings suggest potential differences in DAA efficacy based on HIV coinfection status.
Abstract

Keywords:
DAAHIV infections/*complicationsantiviral agents/administration & dosage/*therapeutic usechronic/*complications/*drug therapyhepatitis Csustained virologic response

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