Virological response rates for telaprevir-based hepatitis C triple therapy in patients with and without HIV coinfection

V. Martel-Laferrière, S. Brinkley, K. Bichoupan, S. Posner, A. Stivala, P. Perumalswami, T. D. Schiano, M. Sulkowski, D. T. Dieterich, A. D. Branch

Research output: Contribution to journalArticle

Abstract

Objectives: Pegylated-interferon/ribavirin dual therapy for hepatitis C virus (HCV) infection has a lower sustained virological response (SVR) rate in HIV/HCV-coinfected patients than in HCV monoinfected patients, but little is known about the relative effectiveness of teleprevir-based triple therapy in the two groups. Methods: Data on 33 coinfected and 116 monoinfected patients were analysed on an intention-to-treat basis. SVR12 was defined as undetectable HCV RNA at week 12 post-end-of-treatment, severe anaemia as haemoglobin ≤89g/L or a drop of ≥45g/L, and advanced fibrosis/cirrhosis as Fib-4 ≥3.25. All coinfected patients had well controlled HIV infection. Results: The groups were similar in age, gender, percentage with Fib-4 ≥3.25 and HCV viral load, but differed in previous treatment response, with more coinfected patients being nonresponders or treatment-intolerant (75.8% vs. 50.0% for monoinfected patients; P<0.01). During treatment, the percentages of patients with undetectable HCV RNA were similar, but, surprisingly, this percentage tended to be higher in coinfected patients. SVR12 rates were 60.6% in coinfected patients vs. 42.2% in monoinfected patients (P=0.06). In multivariable analysis, SVR12 was associated with HIV infection [odds ratio (OR) 3.55; P<0.01], African American race (OR 0.37; P=0.03) and previous treatment response (OR 0.46; P=0.03). Rates of severe anaemia (45.5 vs. 58.6% in coinfected and monoinfected patients, respectively; P=0.18) were similar in the two groups, but rash (15.2 vs. 34.5%, respectively; P=0.03) and rectal symptoms (12.1 vs. 43.1%, respectively; P<0.01) were less common in coinfected patients. Conclusions: Virological responses of coinfected and monoinfected patients did not differ significantly, but tended to be higher in coinfected patients, who had a 60.6% SVR12 rate. Telaprevir-based triple therapy is a promising option for coinfected patients with well-controlled HIV infection.

Original languageEnglish (US)
Pages (from-to)108-115
Number of pages8
JournalHIV Medicine
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • Coinfection
  • HIV
  • Hepatitis C virus
  • Side effects
  • Telaprevir

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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    Martel-Laferrière, V., Brinkley, S., Bichoupan, K., Posner, S., Stivala, A., Perumalswami, P., Schiano, T. D., Sulkowski, M., Dieterich, D. T., & Branch, A. D. (2014). Virological response rates for telaprevir-based hepatitis C triple therapy in patients with and without HIV coinfection. HIV Medicine, 15(2), 108-115. https://doi.org/10.1111/hiv.12086