Higher relapse rate among HIV/HCV-coinfected patients receiving sofosbuvir/ledipasvir for 8 vs 12 weeks - 01/06/19
, Dolores Merino Muñoz b, Francisco Téllez c, d, Rafael Granados e, Luis E. Morano f, Ignacio De Los Santos Gil g, Francisco J. Vera-Méndez h, Antonio Collado i, Rosario Palacios j, Juan A. Pineda aHighlights |
• | SVR rate is lower among HIV/HCV-coinfected patients with 8 vs 12-week SOF/LDV. |
• | This result is mainly driven by a higher proportion of relapses with short therapy. |
• | SVR rate with 8-week SOF/LDV is lower in HIV/HCV-coinfected vs HCV-monoinfected subjects. |
• | Depending on economic issues, SOF/LDV 8-week could be a cost-effective strategy. |
Abstract |
Objectives |
To compare the efficacy of sofosbuvir/ledipasvir (SOF/LDV) for 8 weeks (SL8) versus a 12-week course of SOF/LDV (SL12) among HIV/HCV-coinfected patients in clinical practice. In addition we compared sustained virological response (SVR) rates achieved with SL8 in HCV-monoinfected and HIV/HCV-coinfected patients in a real life setting.
Methods |
HCV-infected patients were retrospectively selected from the HEPAVIR-DAA and GEHEP-MONO real-life prospective cohorts if they fulfilled the following criteria: 1) Infected with genotype 1; 2) Treatment with SL8 or SL12; 3) Treatment naïve prior to receiving SL8 or SL12; 4) Absence of cirrhosis; 5) Baseline HCV RNA<6 × 106 IU/mL; 6) Reached the scheduled time-point for SVR (SVR12) assessment. SVR12 and relapse rates of HCV-monoinfected and HIV/HCV-coinfected patients were compared on an intention to treat basis. The responses with SL8 and SL12 were also compared.
Results |
In the SL8 group, 107 (51%) HCV-monoinfected and 102 (49%) HIV/HCV-coinfected patients were included. One hundred and sixty-four (43%) HCV-monoinfected subjects and 220 (57%) HIV/HCV-coinfected patients received SL12. SVR12 rates for HIV/HCV-coinfected patients treated with SL8 vs SL12 were SVR12 92.2% vs. 97.3% (p = 0.044) and the respective relapse rates were 4.9% vs. 0.5% (p = 0.013). SVR12 rates for SL8 among HCV-monoinfected and HIV/HCV-coinfected patients were: 96.3% vs. 92.2% (p = 0.243), respectively. The corresponding relapse rates were 0.9% vs. 4.9% (p = 0.112).
Conclusion |
HIV/HCV-coinfected patients reach high rates of SVR12 with SL8, although lower than with SL12, mainly due to a higher probability of relapse. SVR12 rates with SL8 are numerically lower and the proportion of relapses higher in HIV/HCVcoinfected patients than in HCV-monoinfected subjects.
Le texte complet de cet article est disponible en PDF.Keywords : Sofosbuvir, Ledipasvir, 8 week treatment, HCV genotype 1, HIV-coinfection, Real-word
Plan
Vol 79 - N° 1
P. 30-35 - juillet 2019 Retour au numéro
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