Sustained virologic response was observed among people with HIV at 12 weeks off-therapy after receiving treatment with direct-acting antivirals (DAAs) for hepatitis C virus (HCV) genotype 6 (HCV-6) infection, according to study findings published in the World Journal of Gastroenterology.
In Taiwan, people with HIV are provided with combination antiretroviral therapy (ART) and health monitoring free-of-charge. In 2019, the HCV treatment program was expanded to provide people with HIV with testing and DAAs. Practicing physicians chose between glecaprevir/pibrentasvir (GLE/PIB), sofosbuvir/ledipasvir (SOF/LDV) +/- ribavirin, SOF/velpatasvir (SOF/VEL) +/- ribavirin, or SOF/daclatasvir (SOF/DCV) +/- ribavirin DAA regimens on the basis of liver status and preference.
In this multicenter, retrospective, observational study, people with HIV with HCV-6 coinfection (N=349) were evaluated for safety and efficacy 12 weeks after treatment conclusion. Efficacy was defined as HCV RNA lower than 30 IU/mL.
At baseline, the study population included 82.5% men, participants had a mean age of 48.9±11.7 years, 80.5% injected drugs, 96.0% had HIV viral loads lower than 50 copies/mL, 94.8% had CD4 counts 200 cells/mm3 or greater, and 10.9% had cirrhosis of the liver.
At DAA initiation, 39.3% were using non-tenofovir disoproxil fumarate (TDF)/tenofovir alafenamide (TAF)-based ART, 34.4% TDF-based ART, and 26.4% TAF-based ART.
The patients were prescribed GLE/PIB (51.9%), SOF/LDV (41.5%), SOF/VEL (6.3%), and SOF/DCV (0.3%) DAA regimens.
At week 12 off-therapy, 92.3% had sustained virologic response, 3.7% had no response, and 4.0% were lost to follow-up. Stratified by injection drug use, no significant difference in the rate of virologic response was observed (92.1% vs 92.9%; P =.999). Similarly, no significant differences in virologic responses were observed on the basis of DAA regimens (range, 91.2%-97.5%; all P >.05).
The people with HIV who received SOF/TDF were associated with significantly decreased estimated glomerular filtration rate (eGFR) during DAA therapy (P £.025), but eGFR improved after DAA discontinuation.
Plasma HIV RNA was maintained at lower than 50 copies/mL among 94.4%.
This study may have been limited by not having access to information about treatment adherence.
The study authors concluded that DAA treatment for HCV-6 was effective and safe among people with HIV.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please refer to the original reference for a full list of authors’ disclosures.
Sun H-Y, Cheng C-Y, Lin C-Y, et al. Real-world effectiveness of direct-acting antivirals in people living with human immunodeficiency virus and hepatitis C virus genotype 6 infections. World J Gastroenterol. 2022;28(11):1172-1183. doi:10.3748/wjg.v28.i11.1172