Position statement of the French Society of Infectious Diseases (SPILF), the French Association for the Study of the Liver (AFEF), the French AIDS Society (SFLS) and the French Society of Internal medicine (SNFMI).
Use of first-generation HCV protease inhibitors in patients coinfected by HIV and HCV genotype 1†
Article first published online: 25 NOV 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
How to Cite
Salmon-Ceron, D., Arvieux, C., Bourlière, M., Cacoub, P., Halfon, P., Lacombe, K., Pageaux, G.-P., Pialoux, G., Piroth, L., Poizot-Martin, I., Rosenthal, E. and Pol, S. (2013), Use of first-generation HCV protease inhibitors in patients coinfected by HIV and HCV genotype 1. Liver International. doi: 10.1111/liv.12363
- Article first published online: 25 NOV 2013
- Accepted manuscript online: 18 OCT 2013 11:55AM EST
- Manuscript Accepted: 13 OCT 2013
- Manuscript Received: 5 APR 2013
- French societies of Infectious Diseases, AIDS, Hepatology and Internal Medicine
- Protease inhibitors;
- HIV/HCV coinfection;
- HCV genotype 1
In HCV genotype 1-infected patients with HIV co-infection, tritherapy [HCV protease inhibitors (PIs) plus peg-interferon and ribavirin] has been shown to have an increased rate of sustained virological response. However, complex drug-to-drug interactions and tolerability issues remain a concern.
Under the auspices of four French scientific societies of medicine, a committee was charged of establishing guidelines on the use of first-generation HCV PIs in these patients. This scientific committee based its work on preliminary results from tritherapy clinical trials in co-infected patients and, since data on these patients are still scarce, on the statements already made by the French Association for the Study of the Liver (AFEF) on the use of tritherapy in HCV mono-infected patients, written in May 2011 and updated in 2012. Each AFEF guideline concerning HCV monoinfection was examined to determine whether it could be used in the context of HIV/HCV coinfection.
These guidelines are addressed for the treatment of coinfected patients with various profiles, including treatment-naïve or patients with failure to previous bitherapy and mention those patients for whom tritherapy should start or those for whom it should be delayed. Preliminary results of triple therapy as well as factors associated to virological response are also discussed. Other issues include virological monitoring, clinical and virological criteria to stop therapy, practical treatment management, treatment adherence and the management of side effects and interactions with antiretroviral drugs. These guidelines were submitted for critical review to independent experts.