Vosevi safe, effective in ‘triple-infected’ patients with HCV, HBV, HIV

PHILADELPHIA – The direct-acting antiviral Vosevi demonstrated an average sustained virologic response rate of 87% among patients who were “triple-infected” with hepatitis C genotype 3, hepatitis B and HIV, as presented at the American College of Gastroenterology Annual Meeting.

“Chronic hepatitis C treatment is no longer challenging in the era of DAAs with an SVR of up to 97%. However, triple infection treatment with HCV, HIV and hepatitis B has not been explored in real life situations,” Nimy John, MD, from the University of Massachusetts Medical School, said during her presentation.

The study comprised 22 patients with HCV, HBV and HIV who underwent a 12-week course of treatment with Vosevi (sofosbuvir/velpatasvir/voxilaprevir, Gilead Sciences).

Ten patients had genotype 3a, nine had genotype 3b, and three had genotype 3c. Nineteen patients were HBV e-antigen negative and three patients were positive.

Four patients stopped treatment due to severe bilateral pneumonia, rectal bleed at 3 weeks of treatment, virologic failure related to resistance-associated substitution (RAS) Y93, or the development of herpes zoster at 10 weeks.

Including the full cohort, the SVR was 87%. However, John noted that all but one patient who completed the 12-week course achieved SVR. The one patient who did not achieve SVR had RAS Y93.

“The study demonstrates the efficacy of DAAs in 12-week treatment with an SVR of 87% in a very challenging triple-infected cohort, with significant efficacy, tolerability and safety,” John said. “A larger trial is needed to validate the results.” – by Talitha Bennett

Reference : Basu P, et al. Abstract 15. Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 5-10, 2018; Philadelphia.

Disclosure: Nimy reports no relevant financial disclosures.