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Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

Effectiveness and safety of IFN-free DAA HCV therapy in HIV/HCV co-infected persons: Results from a pan-European study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Sarah Amele
  • Lars Peters
  • Alison Rodger
  • Jens Lundgren
  • Jϋrgen Rockstroh
  • Raimonda Matulionyte
  • Clifford Leen
  • Elzbieta Jabłonowska
  • Lars Østergaard
  • Sanjay Bhagani
  • Mario Sarcletti
  • Amanda Clarke
  • Karolin Falconer
  • Gilles Wandeler
  • Pere Domingo
  • Fernando Maltez
  • Mauro Zaccarelli
  • Nikoloz Chkhartisvili
  • Janos Szlavik
  • Christoph Stephan
  • Laurent Fonquernie
  • Inka Aho
  • Amanda Mocroft
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OBJECTIVES: To investigate the effectiveness, safety and reasons for premature discontinuation of direct-acting antivirals (DAAs) in a diverse population of HIV/HCV co-infected individuals in Europe.

METHODS: All HIV/HCV co-infected individuals in the EuroSIDA study that started interferon (IFN) free DAA treatment between 1/6/2014 and 1/3/2018 with ≥12 weeks of follow-up after treatment stop were included in this analysis. Sustained virological response (SVR) was defined as a negative HCV-RNA result ≥12 weeks after stopping treatment (SVR12). Logistic regression was used to explore factors associated with SVR12.

RESULTS: 1042 individuals started IFN-free DAA treatment after 1/6/2014 and were included, 862 (82.2%) had a known response to treatment, 789 (91.5%, 95% CI 89.7-93.4) of which achieved SVR12. There were no differences in SVR12 across regions of Europe (p=0.84). After adjustment, the odds of achieving SVR12 was lower in individuals that received sofosbuvir/simeprevir +/- RBV (aOR 0.21 (95% CI 0.08-0.53) or ombitasvir/paritaprevir/dasabuvir +/- RBV (aOR 0.46 (95% CI 0.22-1.00) compared to sofosbuvir/ledipasvir +/- RBV. 43 (4.6%) individuals had one or more components of their HCV regimen stopped early, most commonly due to toxicity (n=14); of these 14, 11 were treated with ribavirin. Increased bilirubin was the most common grade 3 or 4 laboratory adverse event (n=15.3%) and was related to treatment with atazanavir and ribavirin.

CONCLUSIONS: Our findings from real-world data on HIV/HCV co-infected individuals across Europe show DAA treatment is well tolerated, and that high rates of SVR12 can be achieved in all regions of Europe.

TidsskriftJournal of acquired immune deficiency syndromes (1999)
StatusE-pub ahead of print - 15 okt. 2020

ID: 61064175