High efficacy of interferon-free therapy for acute hepatitis C in HIV-positive patients

United European Gastroenterol J. 2019 May;7(4):507-516. doi: 10.1177/2050640619835394. Epub 2019 Mar 6.


Background: The treatment of acute hepatitis C (AHC) with direct-acting antiviral agents (DAAs) is considered a cornerstone of hepatitis C virus (HCV) elimination strategies, especially in human immunodeficiency virus (HIV)-infected individuals at high risk of onward transmission.

Objective: Optimal treatment regimens and duration for AHC in HIV-coinfected patients remain to be established. Thus, we aimed to evaluate the efficacy and safety of DAA treatment regimens in the setting of AHC.

Methods: All HIV-positive patients with a diagnosis of AHC according to the European AIDS Treatment Network (NEAT) consensus attending our clinic after 2014 were included. DAA treatment regimens and duration were based on current recommendations for chronic hepatitis C (CHC) at treatment initiation.

Results: Thirty-eight HIV/AHC patients (median age 42.0 years), mostly men who have sex with men (92%), were started on interferon-free regimens. HCV-genotype (GT) was predominately GT-1a (65%). The following DAA regimens were prescribed: ombitasvir/paritaprevir/ritonavir/dasabuvir (42%; 16/38), glecaprevir/pibrentasvir (29%; 11/38), sofosbuvir/ledipasvir (13%; 5/38), ombitasvir/paritaprevir/ritonavir (5%; 2/38), grazoprevir/elbasvir (5%; 2/38) and sofosbuvir/velpatasvir (5%; 2/38). All HIV/AHC patients achieved sustained virologic response 12 weeks after end of treatment (SVR12) (100%; 38/38). DAA-related adverse events were rare.

Conclusion: Interferon-free DAA regimens (including 34% pan-genotypic regimens) yielded 100% SVR12 in HIV/AHC individuals if treatment durations similar to CHC are applied.

Keywords: Hepatitis C virus; coinfection; human immunodeficiency virus; men who have sex with men.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / adverse effects
  • Coinfection / drug therapy*
  • Coinfection / transmission
  • Coinfection / virology
  • Drug Administration Schedule
  • Elasticity Imaging Techniques
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / transmission
  • HIV Infections / virology
  • Hepacivirus / isolation & purification
  • Hepatitis C / drug therapy*
  • Hepatitis C / transmission
  • Hepatitis C / virology
  • Humans
  • Liver / diagnostic imaging
  • Liver / drug effects
  • Liver / virology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sexual and Gender Minorities
  • Sustained Virologic Response
  • Time Factors


  • Antiviral Agents