Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy?

J Bischoff; S Mauss; C Cordes; T Lutz; S Scholten; A Moll; H Jäger; M Cornberg; M P Manns; A Baumgarten; J K Rockstroh

doi:10.1111/hiv.12579

Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy?

HIV Med. 2018 Apr;19(4):299-307. doi: 10.1111/hiv.12579. Epub 2018 Jan 25.

Authors

J Bischoff¹, S Mauss², C Cordes³, T Lutz⁴, S Scholten⁵, A Moll⁶, H Jäger⁷, M Cornberg⁸, M P Manns⁸, A Baumgarten⁹, J K Rockstroh¹

Affiliations

¹ Department of Medicine I, University Hospital Bonn, Bonn, Germany.
² Center for HIV and Hepatogastroenterology, Duesseldorf, Germany.
³ Praxis Dr. Cordes, Berlin, Germany.
⁴ Infektiologikum, Frankfurt, Germany.
⁵ Dr. Scholten und Schneeweiß GbR, Köln, Germany.
⁶ Praxiszentrum Kaiserdamm, Berlin, Germany.
⁷ MVZ Karlsplatz, Munich, Germany.
⁸ Hannover Medical School, Hannover, Germany.
⁹ Center for Infectious Diseases, Berlin, Prenzlauer Berg, Germany.

PMID: 29368456
DOI: 10.1111/hiv.12579

Abstract

Objectives: The European Association for the Study of the Liver (EASL) treatment recommendations for hepatitis C no longer discriminate between HIV/hepatitis C virus (HCV)-coinfected and HCV-monoinfected patients. However, recent data from Spain are questioning these recommendations on the basis of the findings of higher relapse rates and lower cure rates in HIV/HCV-infected subjects. The aim of our study was to compare HCV cure rates in monoinfected and coinfected patients from Germany.

Methods: Data acquired from the Deutsches Hepatitis C-Registry were analysed. A total of 5657 HCV-monoinfected subjects and 488 HIV/HCV-coinfected patients were included in the study. Rates of sustained virological response 12 weeks after the scheduled end of therapy (SVR12) were collected in both subgroups and in cirrhotic and noncirrhotic patients.

Results: HIV/HCV-coinfected patients were more frequently male (84.6% vs. 56.4%, respectively; P < 0.001) and younger than HCV-monoinfected subjects (46.5 ± 9 vs. 53.8 ± 12.5 years, respectively; P < 0.001). The CD4 blood cell count was > 350 cells/μL in 63.1% of HIV-positive subjects and 88.7% were on antiretroviral therapy. SVR12 rates were 90.3% (5111 of 5657) in our HCV-monoinfected cohort and 91.2% (445 of 488) in our coinfected patients. Liver cirrhosis was confirmed in 1667 of 5657 (29.5%) monoinfected patients and 84 of 488 (17.2%; P < 0.001) coinfected patients. SVR12 rates did not differ between HCV-monoinfected and HIV/HCV-coinfected patients with liver cirrhosis (87.8% vs. 89.3%, respectively; P = 0.864). A treatment duration of 8 weeks did not reduce the percentage of patients with SVR12 in either subgroup (93.7% in both groups).

Conclusions: We found high SVR12 rates in monoinfected as well as coinfected individuals. No differences were detected between the two subgroups regardless of whether there was accompanying liver cirrhosis or a shortened treatment duration.

Keywords: 12-week sustained virological response; chronic hepatitis C; direct-acting antivirals; hepatitis C virus/HIV coinfection; real world effectiveness.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Antiviral Agents / administration & dosage*
Antiviral Agents / pharmacology
CD4 Lymphocyte Count
Cohort Studies
Drug Administration Schedule
Female
Germany
HIV Infections / epidemiology*
HIV Infections / virology
Hepatitis C, Chronic / drug therapy*
Hepatitis C, Chronic / virology
Humans
Liver Cirrhosis / epidemiology*
Male
Middle Aged
Registries
Sustained Virologic Response
Treatment Outcome

Substances

Antiviral Agents