Combination Therapy With Telaprevir for Chronic Hepatitis C Virus Genotype 1 Infection in Patients With HIV

Abstract

In patients with HCV and HIV-1, more adverse events occurred with TVR versus placebo plus PEG-IFN-α2a-ribavirin; these were similar in nature and severity to those in patients with HCV treated with TVR. With or without concomitant antiretrovirals, sustained virologic response rates were higher in patients treated with TVR versus placebo plus PEG-IFN-α2a-ribavirin.

Liver stiffness and aspartate aminotransferase levels predict the risk for liver fibrosis progression in hepatitisCvirus/HIV‐coinfected patients

“…Although sexual transmission of HCV is known to be rather inefficient in discordant heterosexual couples, recent observations suggest that this is the most likely mode of HCV acquisition among HIV-infected men who have sex The progression of HCV-associated liver fibrosis is accelerated among HIV-coinfected patients, and end-stage liver disease complications have emerged as the main cause of morbidity and mortality in this population [7,8]. Therefore, the recommendation to consider anti-HCV treatment in all HIV-coinfected patients [9] should be heeded, taking into account that HCV eradication prevents fibrosis progression [10,11] and leads to a decrease in both liver-related complications and mortality [10][11][12] as well as HIV progression and mortality not related to liver disease [13].However, the low chances of HCV eradication with the combination of interferon (IFN) plus ribavirin (RBV) [12,14], therapy-related toxicities and frequent comorbidities such as active drug addiction or psychiatric disorders all represent serious barriers to HCV treatment in HIV-coinfected patients.The availability of the HCV protease inhibitors telaprevir [15] and boceprevir [16] and of new direct-acting anti-HCV drugs provides multiple treatment choices for all HCV genotypes [17]. Indeed, highly effective complete oral regimens will be available in the near future to eradicate HCV infection even in the most difficult to treat patients [18].…”

Treatment of Acute Hepatitis C Infection with Pegylated Interferon and Ribavirin in Patients Coinfected with Human Immunodeficiency Virus: A Systematic Review and Meta-Analysis

“…The expected sustained virological response (SVR) rates of chronic HCV (c-HCV) to peginterferon and ribavirin (P/R) therapy also diminish considerably, from 50% in treatment-naive monoinfected individuals to 37% in those coinfected and without prior treatment [14,15], which may overestimate real-world outcomes [16]. While preliminary results suggest that the new direct-acting antivirals (DAA) are highly effective for c-HCV [17,18,19], their cost and accessibility limit their availability compared to the traditional P/R regimen in areas where HIV is endemic [20]. …”

A Complex Network of Interactions between S282 and G283 of Hepatitis C Virus Nonstructural Protein 5B and the Template Strand Affects Susceptibility to Sofosbuvir and Ribavirin

“…Ribavirin is a nucleoside analog, with a guanine-like base moiety, that can be incorporated by the HCV RNA-dependent RNA polymerase (RdRp) opposite cytosine or uracil, although the detailed mechanism of action remains elusive (4). In 2011, the first direct-acting antivirals (DAAs) targeting the viral protease, or nonstructural protein 3 (NS3), were approved as a component of IFN-based therapies (5); however, the clinical use of the narrow-spectrum protease inhibitors boceprevir and telaprevir is limited by a narrow coverage of HCV genotypes and a low barrier to the selection of resistance (6). Nucleoside or nucleotide inhibitors (NIs) that target the HCV RdRp, or nonstructural protein 5B (NS5B), address these weaknesses (7).…”