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Effectiveness and Safety of Interferon-Free Direct-Acting Antiviral Hepatitis C Virus Therapy in HIV/Hepatitis C Virus Coinfected Individuals: Results From a Pan-European Study

Amele, S; Peters, L; Rodger, A; Lundgren, J; Rockstroh, J; Matulionyte, R; Leen, C; ... Mocroft, A; + view all (2021) Effectiveness and Safety of Interferon-Free Direct-Acting Antiviral Hepatitis C Virus Therapy in HIV/Hepatitis C Virus Coinfected Individuals: Results From a Pan-European Study. JAIDS Journal of Acquired Immune Deficiency Syndromes , 86 (2) pp. 248-257. 10.1097/QAI.0000000000002541. Green open access

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Abstract

OBJECTIVES: To investigate the effectiveness, safety and reasons for premature discontinuation of direct-acting antivirals (DAAs) in a diverse population of HIV/HCV co-infected individuals in Europe. METHODS: All HIV/HCV co-infected individuals in the EuroSIDA study that started interferon (IFN) free DAA treatment between 1/6/2014 and 1/3/2018 with ≥12 weeks of follow-up after treatment stop were included in this analysis. Sustained virological response (SVR) was defined as a negative HCV-RNA result ≥12 weeks after stopping treatment (SVR12). Logistic regression was used to explore factors associated with SVR12. RESULTS: 1042 individuals started IFN-free DAA treatment after 1/6/2014 and were included, 862 (82.2%) had a known response to treatment, 789 (91.5%, 95% CI 89.7-93.4) of which achieved SVR12. There were no differences in SVR12 across regions of Europe (p=0.84). After adjustment, the odds of achieving SVR12 was lower in individuals that received sofosbuvir/simeprevir +/- RBV (aOR 0.21 (95% CI 0.08-0.53) or ombitasvir/paritaprevir/dasabuvir +/- RBV (aOR 0.46 (95% CI 0.22-1.00) compared to sofosbuvir/ledipasvir +/- RBV. 43 (4.6%) individuals had one or more components of their HCV regimen stopped early, most commonly due to toxicity (n=14); of these 14, 11 were treated with ribavirin. Increased bilirubin was the most common grade 3 or 4 laboratory adverse event (n=15.3%) and was related to treatment with atazanavir and ribavirin. CONCLUSIONS: Our findings from real-world data on HIV/HCV co-infected individuals across Europe show DAA treatment is well tolerated, and that high rates of SVR12 can be achieved in all regions of Europe.

Type: Article
Title: Effectiveness and Safety of Interferon-Free Direct-Acting Antiviral Hepatitis C Virus Therapy in HIV/Hepatitis C Virus Coinfected Individuals: Results From a Pan-European Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAI.0000000000002541
Publisher version: https://doi.org/10.1097/QAI.0000000000002541
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10113215
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