Methods: A retrospective review of outpatient medical records was done of HIV/HCV co-infected patients who were initiated on HCV therapy from January 2014 to December 2015. All had suppressed HIV viremia prior to HCV treatment initiation. HIV/ HCV care was provided by their usual medical providers who consisted of 4 Infectious Disease physicians, 2 internists and 1 physician’s assistant. Referral to hepatologist and medication review by HIV/HCV pharmacist was at the discretion of primary provider. Age, gender, ethnicity, HCV genotype, prior HCV treatment regimen, change in antiretroviral regimen if needed for drug -drug interaction and HCV treatment outcome was collected and tabulated.
Results: 97 patients were initiated on HCV treatment during this 2 year period. 78 were male and 19 female. 42% were Caucasian, 43% black and 15% Hispanic. Age ranged from 31 to 71 years. 69% had advanced liver fibrosis. 57% had genotype 1a, 27% genotype 1b and 5% had genotype 1 which could not be further differentiated. 6% had genotype 2, 4% genotype 3 and 1% genotype 4. 46% were prior treatment experienced which was pegylated interferon with ribavirin (PEG-RIBA) in 69%, PEG-RIBA and protease inhibitor in 25%, simeprevir with sofosbuvir in 4% and PEG-RIBA and sofosbuvir in 2%. 39% were referred for evaluation by hepatologist. Antiretroviral regimen was changed in 35% to facilitate HCV treatment. All 97 received sofosbuvir containing regimen; ledipasvir- sofosbuvir 73%, sofosbuvir -ribavirin 10%, simeprevir-sofosbuvir 7%, PEG-RIBA-sofosbuvir 5%, ledipasvir-sofosbuvir-ribavirin 2%, simeprevir-sofosbuvir-ribavirin 2%. 12 weeks post treatment HCV RNA was available for 90 with 92% sustained virologic response.
Conclusion: HCV therapy can be safely integrated into HIV primary care setting with cure rates similar to clinical trials.
J. Faragon, None
Z. Kingsley, None
J. Cirabisi, None
P. Ells, None