Highly Successful Hepatitis C Virus (HCV) Treatment Outcomes in Human Immunodeficiency Virus/HCV-Coinfected Patients at a Large, Urban, Ryan White Clinic
| Autor: | Manish Patel, Alison Kyle, Ike S. Okosun, Lesley Miller, Aley G. Kalapila, Saira Rab |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Ledipasvir medicine.medical_specialty Sofosbuvir Hepatitis C virus 030106 microbiology Population medicine.disease_cause 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine hepatitis C treatment Internal medicine Major Article Medicine 030212 general & internal medicine education Adverse effect direct-acting antivirals education.field_of_study business.industry Ribavirin virus diseases Retrospective cohort study Infectious Diseases Oncology chemistry Cohort Immunology business HIV/HCV coinfection medicine.drug |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| DOI: | 10.1093/ofid/ofx062 |
| Popis: | Background The introduction of direct-acting antivirals (DAAs) created a major paradigm shift in the treatment of chronic hepatitis C. Currently, there is little “real-world” data regarding hepatitis C virus (HCV) treatment outcomes in the human immunodeficiency virus (HIV)/HCV-coinfected population. Methods This retrospective cohort study examined HCV treatment outcomes of HIV/HCV-coinfected patients at a large, urban, Ryan White-funded clinic caring for an underserved population. All HIV patients initiating HCV treatment from January 1, 2013 to November 30, 2015 were included in the analysis. The primary end point was sustained virologic response 12 weeks after the end of therapy (SVR12). Results A total of 172 patients initiated HCV treatment within the study period: 79% were male, 83% were black, 95% were HCV genotype 1, 79% were HCV treatment naive, and 16% had cirrhosis. At baseline, median CD4 was 494 cells/μL (interquartile range, 316–722) and 92% had HIV ribonucleic acid less than 40 copies/mL. The most common DAA initiated was ledipasvir/sofosbuvir (LDV/SOF) (85%), with 92% receiving 12 weeks of treatment. Overall, SVR12 was 93% by intention-to-treat analysis and 98% by per-protocol analysis. The majority of patients on LDV/SOF did not report any adverse effect. One patient in the ribavirin plus SOF group discontinued treatment due to adverse effect. Conclusions In a cohort of mainly black, male, HIV/HCV-coinfected patients at a large, urban, Ryan White clinic, HCV treatment with DAAs resulted in high SVR12 rates and was well tolerated despite real-world challenges including medication access barriers and drug interaction concerns. |
| Databáze: | OpenAIRE |
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