Real-world effectiveness of direct-acting antivirals in people living with human immunodeficiency virus and hepatitis C virus genotype 6 infections.

Autor: Sun HY; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100225, Taiwan., Cheng CY; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330215, Taiwan., Lin CY; Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County 640203, Taiwan., Yang CJ; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan., Lee NY; Department of Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan., Liou BH; Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsin-Chu 300044, Taiwan., Tang HJ; Department of Internal Medicine, Chi Mei Medical Center, Tainan 710402, Taiwan., Liu YM; Department of Internal Medicine, Changhua Christian Hospital, Changhua 500209, Taiwan., Lee CY; Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan., Chen TC; Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan., Huang YC; Department of Internal Medicine, National Taiwan University Hospital Biomedical Park Branch, Hsin-Chu 302058, Taiwan., Lee YT; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 402306, Taiwan., Tsai MJ; Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County 640203, Taiwan., Lu PL; Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung 807377, Taiwan., Tsai HC; School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan., Wang NC; Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan., Hung TC; Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600566, Taiwan., Cheng SH; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330215, Taiwan., Hung CC; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100225, Taiwan.
Jazyk: angličtina
Zdroj: World journal of gastroenterology [World J Gastroenterol] 2022 Mar 21; Vol. 28 (11), pp. 1172-1183.
DOI: 10.3748/wjg.v28.i11.1172
Abstrakt: Background: Hepatitis C virus (HCV) genotype 6 (HCV-6) infection is prevalent predominantly in Southeast Asia, and the data on the virologic response of HCV-6 to direct-acting antivirals (DAAs) are sparse in people living with human immunodeficiency virus (HIV) (PLWH).
Aim: To assess the virologic response of HCV-6 to DAAs in PLWH.
Methods: From September 2016 to July 2019, PLWH coinfected with HCV-6 initiating DAAs were included. Laboratory investigations were performed at baseline, the end of treatment, and 12 wk off-therapy.
Results: Of the 349 PLWH included (mean age 48.9 years, 82.5% men), 80.5% comprised people who inject drugs, 18.1% men who have sex with men, and 1.4% heterosexuals. Coexistent hepatitis B virus infection was present in 12.3% of the included PLWH, liver cirrhosis 10.9%, hepatocellular carcinoma 0.9%, and previous HCV treatment experience 10.9%. The mean baseline plasma HCV RNA was 6.2 log 10 IU/mL. Treatment with glecaprevir/pibrentasvir was initiated in 51.9%, sofosbuvir/ledipasvir 41.5%, sofosbuvir/velpatasvir 6.3%, and sofosbuvir/daclatasvir 0.3%. At DAA initiation, antiretroviral therapy containing tenofovir alafenamide was given in 26.4%, tenofovir disoproxil fumarate 34.4%, non-tenofovir alafenamide/tenofovir disoproxil fumarate 39.3%, non-nucleoside reverse-transcriptase inhibitors 30.4%, protease inhibitors 4.0%, and integrase strand transfer inhibitors 66.8%; 94.8% of the included patients had CD4 counts ≥ 200 cells/mm 3 and 96.0% had plasma HIV RNA < 50 copies/mL. Overall, 96.8% achieved undetectable plasma HCV RNA (< 30 IU/mL) at end of treatment; and 92.3% achieved sustained virologic response 12 wk off-therapy in the intention-to-treat analysis (93.5% in patients receiving sofosbuvir-based DAAs and 91.2% in those receiving glecaprevir/pibrentasvir).
Conclusion: Similar to the observation made in HIV-negative patients, sustained virologic response 12 wk off-therapy with DAAs is high in PLWH coinfected with HCV-6.
Competing Interests: Conflict-of-interest statement: Hung CC has received research support from Janssen, Merck, Gilead Sciences, and ViiV and speaker honoraria from Abbvie, Bristol-Myers Squibb, Gilead Sciences, and ViiV, and served on advisory boards for Gilead Sciences, Janssen, ViiV, and Abbvie. Sun HY has received research support from Gilead Sciences. Other authors have no competing interest to disclose.
(©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze: MEDLINE
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