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Effectiveness and Safety of Interferon-Free Direct-Acting Antiviral Hepatitis C Virus Therapy in HIV/Hepatitis C Virus Coinfected Individuals: Results from a pan-European study

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  • 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/hepatitis C virus (HCV) coinfected individuals in Europe.

METHODS: All HIV/HCV coinfected individuals in the EuroSIDA study that started interferon free DAA treatment between January 6, 2014, and January 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 interferon-free DAA treatment after 1/6/2014 and were included, 862 (82.2%) had a known response to treatment, and 789 [91.5%, 95% confidence interval (CI): 89.7 to 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 ± ribavirin (RBV) [adjusted odds ratio 0.21 (95% CI: 0.08 to 0.53)] or ombitasvir/paritaprevir/dasabuvir ± RBV [adjusted odds ratio 0.46 (95% CI: 0.22 to 1.00)] compared with sofosbuvir/ledipasvir ± RBV. Forty-three (4.6%) individuals had one or more components of their HCV regimen stopped early, most commonly because of 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 coinfected individuals across Europe show DAA treatment is well tolerated and that high rates of SVR12 can be achieved in all regions of Europe.

Original languageEnglish
JournalJournal of acquired immune deficiency syndromes (1999)
Volume86
Issue number2
Pages (from-to)248-257
Number of pages10
ISSN1525-4135
DOIs
Publication statusPublished - 1 Feb 2021

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