Ledipasvir/Sofosbuvir Effective in Black Patients Co-Infected with HIV/HCV

October 7, 2017

Article

Real world results garnered positive outcomes in the historically difficult-to-treat population.

Black patients co-infected with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) infection saw high rates of sustained virologic response (SVR) when treated with ledipasvir/sofosbuvir (LDV/SOF), according to a real-world study presented at IDWeek in San Diego, CA.

The data supports the overall high efficacy (93%) of LDV/SOF in a difficult to-treat population, according to study authors, led by Jaspreet Banga, MD, MPH, of Rutgers New Jersey Medical School in Newark, NJ.

“Treatment of [HCV] infection for patients with [HIV] has improved with direct acting antivirals (DAAs). However, outcomes among Black persons treated with [LDV/SOF] may be inferior to non-Blacks,” the authors wrote. “We assessed responses to LDV/SOF in a cohort of Black HIV/HCV co-infected persons in Newark, New Jersey.”

Researchers conducted retrospective chart reviews for Black, genotype 1 (GT1) HIV/HCV co-infected patients treated with LDV/SOF at three hospitals in Newark between January 2014 and July 2016. 117 HIV/HCV co-infected Black patients started treatment with LDV/SOF and 107 completed LDV/SOF at all three hospitals. The study population was 65% male with a median age of 58 years. 26% of patients had cirrhosis and 77% had GT1a. 31% were treatment experienced, but none had undergone prior NS5a treatment.

At baseline, median CD4 count was 680 cells/mm³, HIV viral load (VL) was <40 in 94% and median HCV VL was 2257403 IU/mL. 29% of patients changed antiretroviral treatment (ART) before LDV/SOF treatment because of drug reactions.

6, 89 and 12 patients completed 8, 12 and 24 weeks of LDV/SOF respectively, however, there were not enough patients [n=6] in the 8-week arm to assess its efficacy.

Overall, only 7 patients relapsed and 93% of patients [n=100] achieved sustained virologic response at 12 weeks (SVR12), This included 67% of patients [n=4] in the 8 week arm, 96% of patients [n=85] in the 12 week arm and 92% of patients [n=11] in the 24 week arm.

When judged by ART class, this population saw a similar success rate. 95% of patients [n=62] on INSTI achieved SVR12, followed by 93 % of patients [n=13] on PI, 80% of patients [n=4] who included efavirenz and 91% of patients [n=21] on other ART therapies.