Virological response rates for telaprevir-based hepatitis C triple therapy in patients with and without HIV coinfection
Article first published online: 11 SEP 2013
© 2013 British HIV Association
Volume 15, Issue 2, pages 108–115, February 2014
How to Cite
Martel-Laferrière, V., Brinkley, S., Bichoupan, K., Posner, S., Stivala, A., Perumalswami, P., Schiano, T., Sulkowski, M., Dieterich, D. and Branch, A. (2014), Virological response rates for telaprevir-based hepatitis C triple therapy in patients with and without HIV coinfection. HIV Medicine, 15: 108–115. doi: 10.1111/hiv.12086
- Issue published online: 7 JAN 2014
- Article first published online: 11 SEP 2013
- Manuscript Accepted: 6 AUG 2013
- National Institutes of Health. Grant Numbers: DA031095, DK090317
- National Institute on Drug Abuse. Grant Numbers: K24 DA034621/DA/NIDA, R01 DA016065-10/DA/NIDA
- 2011 AMMI Canada/Pfizer Post-Residency Fellowship
- 2012 Grant of the CHUM Foundation
- hepatitis C virus;
- side effects
Pegylated-interferon/ribavirin dual therapy for hepatitis C virus (HCV) infection has a lower sustained virological response (SVR) rate in HIV/HCV-coinfected patients than in HCV monoinfected patients, but little is known about the relative effectiveness of teleprevir-based triple therapy in the two groups.
Data on 33 coinfected and 116 monoinfected patients were analysed on an intention-to-treat basis. SVR12 was defined as undetectable HCV RNA at week 12 post-end-of-treatment, severe anaemia as haemoglobin ≤ 89 g/L or a drop of ≥ 45 g/L, and advanced fibrosis/cirrhosis as Fib-4 ≥ 3.25. All coinfected patients had well controlled HIV infection.
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 coinfected patients being nonresponders or treatment-intolerant (75.8% vs. 50.0% for monoinfected patients; P < 0.01). During treatment, the percentages of patients with undetectable HCV RNA were similar, but, surprisingly, this percentage tended to be higher in coinfected patients. SVR12 rates were 60.6% in coinfected patients vs. 42.2% in monoinfected patients (P = 0.06). In multivariable analysis, SVR12 was associated with HIV infection [odds ratio (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 anaemia (45.5 vs. 58.6% in coinfected and monoinfected patients, respectively; P = 0.18) were similar in the two groups, but rash (15.2 vs. 34.5%, respectively; P = 0.03) and rectal symptoms (12.1 vs. 43.1%, respectively; P < 0.01) were less common in coinfected patients.
Virological responses of coinfected and monoinfected patients did not differ significantly, but tended to be higher in coinfected patients, who had a 60.6% SVR12 rate. Telaprevir-based triple therapy is a promising option for coinfected patients with well-controlled HIV infection.