Direct-acting antivirals for acute hepatitis C in HIV-infected MSM

Safety and efficacy of sofosbuvir‐based treatment of acute hepatitis C in end‐stage renal disease patients undergoing haemodialysis

“…Liu et al have reported a case of overlap syndrome in acute HCV infection (through blood transfusion) that was treated with sofosbuvir and ribavirin for 12 weeks . Millard et al reported four cases of AHC in HIV‐infected men who have sex with men; these patients were treated with Harvoni (400 mg sofosbuvir plus 90 mg ledipasvir), once per day, for 8‐12 weeks . To date, only one small study has been conducted investigating DAAs treatment for AHC.…”

Successful treatment of sexually acquired acute HCV reinfection with ledipasvir/sofosbuvir in a HIV-infected patient

“…21 In the ION-4 trial, LDV/SOF for 12 weeks provided a 96% SVR rate in 335 patients chronically coinfected with HIV/HCV genotypes 1 and 4. 22 Although there are very limited data on LDV/SOF in AHC patients with HIV coinfection, 20 similar, or even superior, SVR rates and tolerability profile are expected. Furthermore, there is evidence for the possible efficacy of four-week to six-week courses of LDV/SOF or other DAA combination therapy in both non-HIV and HIV-positive patients with acute HCV infection, which makes the treatment of AHC cost-saving as compared to treatment of CHC.…”

“…Treatment of AHC with PEG-IFN-a and ribavirin for 24-48 weeks in HIV-infected patients resulted in overall SVR rates of 53-91% 12,15,16 ; the addition of first-generation DAAs telaprevir or boceprevir in acute HCV genotype-1 infection yielded SVR rates of 84-86% after 12 weeks of treatment, but at the cost of frequent toxic effects 17,18 ; IFN-free regimens with second-generation DAAs endowed with greater activity and tolerability now promise to further improve SVR rates after 12 (or less) weeks of treatment. 19,20 With new DAAs still only being licensed for chronic HCV infection and advanced liver fibrosis in most resource-rich and almost all resource-limited countries, HIV-coinfected patients with AHC currently have two options: (1) treatment with PEG-IFN-a and ribavirin for 24-48 weeks or (2) no treatment until the development of chronic phase and, in most cases, advanced liver disease, when they may have access to IFN-free DAA regimens. However, the first option seems disadvantageous in terms of SVR rates, treatment duration and side effects compared with all-oral DAA regimens in CHC; the second option seems even more detrimental, due to the ongoing AHC epidemic and to the greater risk for HCV persistence and faster progression to cirrhosis in HIV-coinfected compared to HCV-monoinfected patients.…”

Acute Hepatitis C Virus Infection and Directly Acting Anti-Hepatitis C Virus Drugs

“…Coming to the era of polymerase inhibitors, sofosbuvir with ribavirin regimen was firstly tested in the NYC II on genotypes 1 HIV/HCV co-infected patients for 12 weeks mounting SVR achievement in 92% [26]. The same regimen was retested in SWIFT-C study on genotype 1 and 4 co-infected patients for the same duration, with only 59% of patients achieved SVR [27].…”