The management of HCV-infected patients is rapidly evolving. Data suggest that HIV/HCV-coinfected patients treated with oral HCV regimens have sustained virologic response rates comparable to those of HCV-monoinfected patients. However, there are limited data regarding effectiveness of direct-acting antivirals (DAA) for HIV/HCV co-infected patients in real-world clinical settings.
Main Objective: To evaluate the effectiveness of Ledipasvir/sofosbuvir in suppressing HCV viral load among HIV/HCV co-infected patients at Nassau University Medical Center, New York from December 2014 to December 2015.
The study was conducted using retrospective data from HIV/HCV clinic. The study population included patients co-infected with HIV and HCV who received HCV treatment with Ledipasvir/sofosbuvir in the clinic, based on the current IDSA guideline. Primary outcome was sustained viral response 12 weeks after finishing HCV therapy (SVR12). Different variables (HCV genotype, Treatment naïve, Cirrhosis, Baseline HCV viral load) were assessed for viral response.
Twenty-three HIV/HCV co-infected patients with mean CD4 count of 777cells/mm³ were treated. All patients received HAART and 96% were with undetectable HIV viral load. 61% were male, mean age was 59 years and most were African American. All have type 1 HCV genotype with 1a accounting to 78%. The mean baseline HCV viral load before treatment was higher than 2.6 million. 57% had fibrosis/cirrhosis and 44% had failed prior treatment. Our data indicated that 95.2% achieved SVR. The SVR rates were 83% and 92% in caucasians and male respectively. There was no significant association between HCV baseline viral load and SVR. The SVR rates were 100% in treatment naïve patients, genotype 1b patients and interestingly those with fibrosis/cirrhosis. No patient discontinued treatment due to adverse effects.
The overall SVR rate of Ledipasvir/sofosbuvir for HCV/HIV co-patients in real-world clinical setting was 95.2%. Our analysis indicated that once-daily, single tablet regimen of Ledipasvir/sofosbuvir was well-tolerated and provided high rates of SVR in HIV/HCV co-infected patients. We recommend that collaborative efforts should focus on scaling-up HCV treatment among HIV patients.
H. Pahlevan, None