Hepatitis C virus treatment response to ledipasvir/sofosbuvir among patients coinfected with HIV and HCV

Abstract

Treatment of hepatitis C virus (HCV) infection for patients with human immunodeficiency virus (HIV) has improved with direct acting antivirals. However, outcomes among Black persons treated with ledipasvir/sofosbuvir (LDV/SOF) may be inferior to non-Blacks. We assessed responses to LDV/SOF in a cohort of Black HIV/HCV coinfected persons. Retrospective chart reviews were conducted for Black, genotype 1 (GT1), HIV/HCV coinfected patients treated with LDV/SOF at 3 hospitals in Newark, NJ between January 2014 and July 2016. Data collected included demographics, HCV treatment history, treatment duration, and response. One hundred seventeen HIV/HCV coinfected Black patients started treatment with LDV/SOF but 5 had no follow-up data and 5 prematurely discontinued treatment (1 due to side effects). We included 107 HIV/HCV coinfected patients who completed LDV/SOF at all 3 sites. The study population was 65% male, median age 58 years, 26% had cirrhosis, and 78% had GT1a. Thirty-one percent were treatment experienced but none with prior NS5a treatment. At baseline, median CD4 count was 680 cells/mm 3 , HIV viral load (VL) was <40 copies/mL in 94% and median HCV VL was 2,257,403 IU/mL. Twenty-nine percent of patients changed antiretroviral treatment before LDV/SOF treatment due to drug interactions. Six, 89, and 12 patients completed 8, 12, and 24 weeks of LDV/SOF, respectively. Overall sustained virologic response rate was 93% with 7 relapses. In this real-world cohort of Black, GT1, HIV/HCV coinfected patients, LDV/SOF had high sustained virologic response 12 weeks post completion of treatment rate of 93%. This data supports the overall high efficacy of LDV/SOF in a historically difficult-to-treat patient population.

Febre amarela: pesquisa de polimorfismos do INF- e associação com o desfecho da doença

“…Acreditamos que esse resultado reflete a não exposição desse grupo às matas ou aos locais de maior transmissão, além de, muitos idosos já estarem vacinados contra a doença. Paralelamente, quando analisamos os grupos étnicos, observamos que os pretos são mais suscetíveis a FA quando comparados aos outros grupos -dado que corrobora com os achados em HCV descritos por Rana Asali Hogarth em 2019(67) e por Jaspreet Banga, et al em 2020(68).Várias limitações foram observadas em nosso estudo e precisam ser reconhecidas. Primeiro, sabemos que a casuística deste estudo foi e é um fator limitante já que em estudos de frequência de polimorfismos costumam apresentar um N amostral maior do que temos neste trabalho.…”