Objectives
Pegylated-interferon/ribavirin dual therapy for hepatitis C virus (HCV) has a lower sustained virologic response (SVR) rate in HIV/HCV-co-infected patients than in HCV mono-infected patients, but little is known about the relative effectiveness of teleprevir-based triple therapy in the two groups.
Methods
Data on 33 co-infected and 116 mono-infected patients were analyzed on an intention-to-treat basis. SVR12 was defined as undetectable HCV RNA at week-12 post-end-of-treatment, severe anemia as hemoglobin ≤89 g/L or a drop ≥45 g/L, and advanced fibrosis/cirrhosis as Fib-4 ≥3.25. All co-infected patients had well-controlled HIV.
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 co-infected patients non responders/treatment intolerant (75.8% vs. 50.0%, <0.01). During treatment, the percentages of patients with undetectable HCV RNA were similar, but, surprisingly, tended to be higher in co-infected patients. SVR12 rates were 60.6% (co-infected) vs. 42.2% (mono-infected), p=0.06. In multivariable analysis, SVR12 was associated with HIV infection (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 anemia (45.5% vs. 58.6%, p=0.18) were similar in the two groups, but rash (15.2% vs. 34.5%, p=0.03) and rectal symptoms (12.1% vs. 43.1%, p<0.01) were less common in co-infected patients.
Conclusions
Virologic responses of co- and mono-infected patients did not differ significantly, but tended to be higher in co-infected patients, who had a 60.6% SVR12 rate. Telaprevir-based triple therapy is a promising option for co-infected patients with well-controlled HIV.