IFN-free therapy for HIV/HCV-coinfected patients within the liver transplant setting

Londoño, María-Carlota; Manzardo, Christian; Rimola, Antoni; Ruíz, Pablo; Costa, Josep; Forner, Alejandro; Ambrosioni, Juan; Agüero, Fernando; Laguno, Montserrat; Lligoña, Anna; Moreno, Asunción; Miró, J. M.

doi:10.1093/jac/dkw270

Cited by 11 publications

(6 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Grant et al found an SVR rate of 87% in eight patients with recurrence of mild hepatitis C treated with a SOF‐based combination. Campos‐Varela et al reported a 100% SVR in two HCV/HIV‐coinfected patients with recurrence of hepatitis C. Similarly, we reported a 100% SVR in seven patients with severe hepatitis C, four of whom had decompensated cirrhosis . Castells et al reported 100% SVR in six HCV/HIV‐coinfected patients treated with SOF + DCV.…”

Section: Discussionsupporting

confidence: 76%

“…Despite growing data on the safety and efficacy of antiviral therapy in HIV‐negative HCV‐infected LT recipients, data on HCV/HIV‐coinfected LT recipients remain scarce and are based only on small case series . We report the results of the first nationwide, multicenter, prospective case‐control study on the effectiveness and tolerability of antiviral therapy with DAAs in HCV/HIV‐coinfected patients with recurrence of hepatitis C after LT and a matched cohort of monoinfected recipients.…”

Section: Discussionmentioning

confidence: 99%

“…Eight patients experienced serious adverse events, although none were related to therapy. In a recent series of seven HCV/HIV‐coinfected LT recipients with severe HCV recurrence taking different combinations of DAAs, all seven patients achieved SVR, and only four experienced mild adverse events . In another study, one patient treated with SOF and daclatasvir (DCV) presented severe bradycardia .…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study

Manzardo

Londoño

Castells

et al. 2018

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

Direct-acting antivirals have proved to be highly efficacious and safe in monoinfected liver transplant (LT) recipients who experience recurrence of hepatitis C virus (HCV) infection. However, there is a lack of data on effectiveness and tolerability of these regimens in HCV/HIV-coinfected patients who experience recurrence of HCV infection after LT. In this prospective, multicenter cohort study, the outcomes of 47 HCV/HIV-coinfected LT patients who received DAA therapy (with or without ribavirin [RBV]) were compared with those of a matched cohort of 148 HCV-monoinfected LT recipients who received similar treatment. Baseline characteristics were similar in both groups. HCV/HIV-coinfected patients had a median (IQR) CD4 T-cell count of 366 (256-467) cells/µL. HIV-RNA was <50 copies/mL in 96% of patients. The DAA regimens administered were SOF + LDV ± RBV (34%), SOF + SMV ± RBV (31%), SOF + DCV ± RBV (27%), SMV + DCV ± RBV (5%), and 3D (3%), with no differences between the groups. Treatment was well tolerated in both groups. Rates of SVR (negative serum HCV-RNA at 12 weeks after the end of treatment) were high and similar for coinfected and monoinfected patients (95% and 94%, respectively; P = .239). Albeit not significant, a trend toward lower SVR rates among patients with advanced fibrosis (P = .093) and genotype 4 (P = .088) was observed. In conclusion, interferon-free regimens with DAAs for post-LT recurrence of HCV infection in HIV-infected individuals were highly effective and well tolerated, with results comparable to those of HCV-monoinfected patients.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study

Manzardo

Londoño

Castells

et al. 2018

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

show abstract

“…Regarding antiviral treatment of patients awaiting a LT, a study by Londoño et al reported 4 patients with compensated cirrhosis and HCC who received IFN‐free antiviral treatment, all of them achieving SVR and with no tolerability issues. Recently, an Italian multicenter study reported the results of 24 HIV patients with cirrhosis who were treated during the pretransplant period, of whom 20 were decompensated (Child‐Pugh B and C).…”

Section: Discussionmentioning

confidence: 99%

“…Notably, 3 out of these 20 patients received peginterferon as part of their therapy. In the previously mentioned study by Londoño et al, 7 HIV‐infected LT recipients received IFN‐free antiviral treatment for severe HCV recurrence, either fibrosing cholestatic hepatitis (FCH), advanced fibrosis (F3), or decompensated graft cirrhosis. All of the patients achieved SVR.…”

Section: Discussionmentioning

confidence: 99%

Peritransplant Antiviral Treatment of Human Immunodeficiency Virus/Hepatitis C Virus–Coinfected Patients

Vinaixa

Aguilera

Blanes³

et al. 2018

Liver Transpl

View full text Add to dashboard Cite

TO THE EDITOR:The availability of direct-acting antivirals (DAAs) has transformed the treatment scenario in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)coinfected patients with sustained virological response (SVR) results over 90%-95%. In the peritransplant setting, there are few real-world experiences in treating patients with HIV/HCV coinfection.Our aims were to describe the outcomes of antiviral treatment with DAA in HIV/HCV-coinfected patients in terms of efficacy, safety, and drug-drug interactions (DDIs) in the pretransplant (waiting list [WL]) and posttransplant settings and to compare these results to HCV-monoinfected patients. MethodsWe conducted a retrospective and observational case-control study in a single center, Hospital Universitario y Politécnico La Fe (Valencia, Spain), which was approved by the local institutional review board. All HIV/HCV-coinfected patients who initiated HCV antiviral treatment with interferon (IFN)-free regimens from March 2014 to March 2016 either on the WL for liver transplantation (LT) or after LT were included. Each HIV/HCV-coinfected patient was matched with 2 HCV-monoinfected patients by HCV genotype (when possible), fibrosis stage, and treatment regimen, and, in the case of cirrhosis, with Model for End-Stage Liver Disease (MELD) and Child-Pugh scores.Treatment regimen choice was based on drug availability at each time point, as given by compassionate-use programs and progressive drug commercialization.Data were collected per local standard of care and at different time points: baseline (pretreatment), ontreatment (weeks 4, 12, and 24), and after treatment (weeks 4, 12, 24, and 48). Patients were followed up to 2 years since treatment initiation.For the descriptive analysis, quantitative variables are presented as median and/or mean and interquartile ranges (IQRs) or range, while categorical variables are presented as frequencies and percentages. Differences between categorical variables were assessed by chisquare test. Continuous variables were compared using the Student t test. All data were analyzed using STATA, version 12 (Stata Corp., College Station, TX). ResultsNine HIV/HCV-coinfected patients on the WL for LT were included, matched to 18 HCV-monoinfected patients in the control group. A total of 14 HIV/HCVcoinfected LT recipients with HCV recurrence receiving 15 antiviral treatments (1 patient was retreated after relapse) were included, matched to 30 HCVmonoinfected patients in the control group. Baseline features of pretransplant and posttransplant patients are summarized in Table 1. Notably, 11% of patients included (8/45) received a sofosbuvir (SOF) + ribavirin (RBV) regimen, which is not currently the recommended standard of care but was the only available regimen at the moment (see Table 1).

show abstract

Hepatic Transplantation and HBV, HCV, and HIV Infections

Terrault

2018

Sherlock's Diseases of the Liver and Biliary System

View full text Add to dashboard Cite

IFN-free therapy for HIV/HCV-coinfected patients within the liver transplant setting

Abstract: IFN-free regimens are effective and well tolerated in HIV/HCV-coinfected patients within the LT setting, but more data are needed to confirm our promising results and to establish the best treatment option in this population.

Cited by 11 publications

References 37 publications

Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study

Direct-acting antivirals are effective and safe in HCV/HIV-coinfected liver transplant recipients who experience recurrence of hepatitis C: A prospective nationwide cohort study

Peritransplant Antiviral Treatment of Human Immunodeficiency Virus/Hepatitis C Virus–Coinfected Patients

Hepatic Transplantation and HBV, HCV, and HIV Infections

Contact Info

Product

Resources

About