Hepatitis C Treatment Is Safe, Effective in Some HIV Patients

Treatment of hepatitis C virus (HCV) infection is safe and effective in patients with chronic HCV with or without human immunodeficiency virus (HIV) across sub-Saharan Africa, according to a recent study.

Findings were presented at the 9th International AIDS Society Conference on HIV Science, which took place from July 23-26, 2017, in Paris, France.
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Elimination of HCV has become realistic with the advent of highly effective direct-antiviral agents against chronic HCV and the recent commitment of the World Health Organization. However, HCV remains prevalent in sub-Saharan Africa, where access to care and treatment is almost nonexistent.

In the TAC ANRS 12311 trial, the researchers evaluated 120 participants with chronic HCV without decompensated cirrhosis across Senegal, Côte d'Ivoire, and Cameroon. All participants were naïve to HCV treatment. Participants with genotype (GT) 2 received sofosbuvir plus weight-based ribavirin (SOF+RBV) for 12 weeks, while participants infected with GT-1 or GT-4 received sofosbuvir plus ledipasvir (SOF+LDV).

Demographic information indicated that 55% of participants were male, and the median age of participants was 58 years.

Of the first 110 participants evaluated in the study, 33 had GT-1, 40 had GT-2, and 37 had GT-3. Median plasma HCV-RNA among participants was 6.0 logIU/mL. A total of 32 participants also had HIV, 11 had cirrhosis, and all participants had plasma HIV-RNA of less than 200 copies/MI.

Results indicated that 4 patients experienced a hemoglobin decrease between 85 and 100 g/L, with 2 having a consequent reduction of RBV dosage. HCV-RNA measurements taken at week 24 showed that 98 participants (89%) had had an undetectable viral load. Of these participants, 29 had GT-1, 36 had GT-2, and 33 had GT-4.

A total of 12 patients failed treatment, with 3 of these patients having had cirrhosis at baseline. Furthermore, only 1 patient discontinued treatment for a personal reason, and there were no severe adverse events among participants.

“In this interim analysis, HCV treatment appeared to be feasible, safe, and effective in sub-Saharan Africa including in HIV co-infected patients,” the researchers concluded. “With the growing access to HCV drugs at generic price worldwide, it is time to prompt scaling up of HCV care and management in Africa.”

—Christina Vogt

Reference:

Lacombe K, Moh R, Chazallon C, et al. Treatment of chronic hepatitis C genotype 1, 2 and 4 in patients with or without HIV and living in Central or West Africa: the TAC ANRS 12311 trial. Paper presented at: 9th International AIDS Society Conference on HIV Science; July 23-26, 2017. Paris, France. http://programme.ias2017.org/Abstract/Abstract/5838.