World J Hepatol. 2015 Aug 28;7(18):2177-83. doi: 10.4254/wjh.v7.i18.2177.

Virological response and resistance mutations to NS3/4A inhibitors in hepatitis C virus-human immunodeficiency virus coinfection.

World journal of hepatology

Alissa Naqvi, Valérie Giordanengo, Brigitte Dunais, Francine de Salvador-Guillouet, Isabelle Perbost, Jacques Durant, Pascal Pugliese, Aline Joulié, Pierre Marie Roger, Eric Rosenthal, Mondi, Giovanelli

PMID: 26328030 PMCID: PMC4550873 DOI: 10.4254/wjh.v7.i18.2177

Abstract

AIM: To evaluate virological response to telaprevir or boceprevir in combination with pegylated interferon and ribavirin and resistance mutations to NS3/4A inhibitors in hepatitis C virus-human immunodeficiency virus (HCV-HIV) coinfected patients in a real life setting.

METHODS: Patients with HCV genotype 1-HIV coinfection followed in Nice University Hospital internal medicine and infectious diseases departments who initiated treatment including pegylated interferon and ribavirin (PegIFN/RBV) + telaprevir or boceprevir, according to standard treatment protocols, between August 2011 and October 2013 entered this observational study. Patient data were extracted from an electronic database (Nadis(®)). Liver fibrosis was measured by elastometry (Fibroscan(®)) with the following cut-off values: F0-F1: < 7.1 kPa, F2: 7.1-9.5 kPa, F3: 9.5-14.5 kPa, F4: ≥ 14.5 kPa. The proportion of patients with sustained virological response (SVR) twelve weeks after completing treatment, frequency and type of adverse events, and NS3/4A protease inhibitor mutations were described.

RESULTS: Forty-one patients were included: 13 (31.7%) patients were HCV-treatment naïve, 22 (53.7%) had advanced liver fibrosis or cirrhosis (Fibroscan stage F3 and F4); none had decompensated cirrhosis or hepatocellular carcinoma; all were receiving antiretroviral treatment, consisting for most them (83%) in either a nucleoside reverse-transcriptase inhibitor/protease inhibitor or/integrase inhibitor combination; all patients had undetectable HIV-RNA. One patient was lost to follow-up. SVR was achieved by 52.5% of patients. Five patients experienced virological failure during treatment and four relapsed. Seven discontinued treatment due to adverse events. Main adverse events included severe anemia (88%) and rash (25%). NS3/4A protease mutations were analyzed at baseline and at the time of virological failure in the 9 patients experiencing non-response, breakthrough or relapse. No baseline resistance mutation could predict resistance to HCV protease inhibitor-based treatment.

CONCLUSION: Telaprevir and boceprevir retain their place among potential treatment strategies in HIV-HCV coinfected patients including those with advanced compensated liver disease and who failed previous PegIFN/RBV therapy.

Keywords: Boceprevir; Hepatitis C virus-human immunodeficiency virus coinfection; Resistance mutations; Telaprevir

References

1. Curr HIV/AIDS Rep. 2013 Dec;10(4):408-19 - PubMed
2. J Hepatol. 2013 Sep;59(3):434-41 - PubMed
3. AIDS. 2013 May 15;27(8):1356-9 - PubMed
4. J Med Virol. 2014 Nov;86(11):1868-76 - PubMed
5. Clin Infect Dis. 2014 Dec 15;59(12 ):1768-76 - PubMed
6. J Med Virol. 2013 Jun;85(6):1028-36 - PubMed
7. J Clin Microbiol. 2013 May;51(5):1428-33 - PubMed
8. Clin Infect Dis. 2013 Jul;57(2):221-9 - PubMed
9. Antivir Ther. 2011;16(7):1093-102 - PubMed
10. HIV Med. 2009 Sep;10(8):504-11 - PubMed
11. Ann Intern Med. 2013 Jul 16;159(2):86-96 - PubMed
12. Lancet Infect Dis. 2013 Jul;13(7):597-605 - PubMed

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