Real-life effectiveness of antiviral therapy for HCV infection with pangenotypic regimens in HIV coinfected patients

ABSTRACT

Background

The aim of this study was to evaluate the real-life efficacy of pangenotypic antivirals in HIV-HCV-positive patients.

Research design and methods

The analysis included 5650 subjects who were treated with pangenotypic anti-HCV drugs: 5142 were HCV-positive and 508 were HIV-HCV-positive.

Results

Patients with HCV-monoinfection were older (p < 0.0001), however patients with HCV-monoinfection had a higher proportion of advanced fibrosis F4 (p < 0.0001). There were no differences between the study groups in the rate of SVR12 in ITT-analysis (87,6% versus 93,9% in coinfection and monoinfection group, respectively; p > 0.05). However, there was a difference between study groups in PP-analysis, HIV/HCV and HCV, respectively 95.9% vs 97.9%, p = 0.0323. Additionally, there were a higher rate of patients who did not apply for follow-up (SVR12) in coinfected patients (7,9% vs 3,6% respectively p = 0.0001). In multivariante analysis, factors associated with worse response to the pangenotypic anti-HCV therapy included male sex, HCV genotype 3, stage of fibrosis and decompensation of liver function and HIV coinfection.

Conclusions

The real-life results of pangenotypic anti-HCV treatment are veryeffective in the group of HIV-HCV-coinfected patients. However, the finaleffectiveness is slightly lower than that obtained in HCV monoinfectedpatients.

KEYWORDS:

• Pangenotypic treatment
• HCV/HIV coinfection
• hepatitis C
• sustained viral response
• direct acting antivirals

Article highlights

• Pangenotypic anti-HCV treatment differs significantly between HCV-monoinfected and HIV-HCV-coinfected patients.

• Factors associated with worse response to the DAA therapy included male sex, HCV genotype 3, stage of fibrosis and decompensation of liver function and HIV coinfection.

• In the group of HIV-HCV-coinfected patients frequent treatment discontinuation is observed.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors made substantial contributions to the conception and design of the study and interpreting the findings. All authors were involved in writing the article and revised it for intellectual content.

Additional information

Funding

This paper was not funded.