471. Outcome of Chronic Hepatitis C infection in HIV Co-infected with Sofosbuvir containing Regimens in HIV Primary Care Setting with Integration of New York State Department of Health Funding Support
Session: Poster Abstract Session: Hepatitis C
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • 56 x 42 ID Week Poster 2016.pdf (537.3 kB)
  • Background:  To support and enhance the capacity to provide hepatitis C medical care and treatment through the integration of services into our Ryan White Part C funded Human Immunodeficiency Virus (HIV) primary care setting, additional grant funding from New York State Department of Health provided partial salary support for a hepatologist, hepatitis C nurse coordinator and peer advocate. A 2-year retrospective study was done to determine clearance of Hepatitis C Virus (HCV) 12 weeks after completion of HCV treatment in HIV co-infected.

    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.

    Madhuchhanda Choudhary, MD1, Shelley Gilroy, MD1, John Faragon, PharmD2, Zoe Kingsley, RN2, Joseph Cirabisi, Peer Advocate2 and Peter Ells, MD1, (1)Medicine, Albany Medical College, Albany, NY, (2)Albany Medical College, Albany, NY

    Disclosures:

    M. Choudhary, None

    S. Gilroy, None

    J. Faragon, None

    Z. Kingsley, None

    J. Cirabisi, None

    P. Ells, None

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