Telaprevir-based therapy did not increase SVR in HCV/HIV coinfection

Men who have sex with men presenting with hepatitis C genotype 1 infection and HIV-1 coinfection did not experience increased rates of sustained virologic response after treatment with telaprevir plus pegylated interferon and ribavirin vs. those assigned therapy with pegylated interferon and ribavirin alone, according to data from a pilot study presented at AIDS 2016.

“None of the currently available direct-acting antivirals have been licensed for treatment of acute hepatitis C coinfection,” Christoph Boesecke, MD, of the department of medicine, Bonn University Hospital, Germany, told Infectious Disease News. “However, with the [acute hepatitis C coinfection] epidemic still ongoing among HIV-positive men who have sex with men, these are urgently needed.”

Christoph Boesecke

In the CHAT study, Boesecke and colleagues randomly assigned 34 patients with acute HCV genotype 1 infection and HIV-1 coinfection (AHC) from six clinical centers in Germany (n = 14) and one center in Great Britain (n = 20) to receive therapy with telaprevir plus pegylated interferon and ribavirin (n = 19) or pegylated interferon and ribavirin alone (n = 15) for 12 weeks.

Almost 80% of the full cohort attained SVR12. Eighty percent of patients who received therapy with pegylated interferon and ribavirin alone (n = 12) reached SVR12 compared with 78.9% of patients who received therapy with telaprevir plus pegylated interferon and ribavirin (n = 15).

Of the patients who received telaprevir but did not achieve SVR12 (n = 4), one experienced a virologic breakthrough, and two were nonresponders. One patient discontinued telaprevir due to severe epidermolysis. Ribavirin dose reduction (44% vs. 0%), anemia (33% vs. 20%) and rash (67% vs. 20%) were more frequent in patients treated with pegylated interferon and ribavirin alone vs. those assigned telaprevir and ribavirin.

“Although telaprevir-containing triple therapy offers the advantage of shortened treatment duration in acute HCV coinfection, treatment is associated with additional toxicities while not leading to higher SVR rates,” Boesecke and colleagues wrote. “Therefore, with the AHC epidemic still ongoing, licensing of highly effective and well-tolerated [interferon]-free DAA regimens for treatment of AHC is urgently needed.” – Melinda Stevens

Reference:

Boesecke C, et al. Abstract WEPEB063. Presented at: International AIDS Conference; July 18-22, 2016; Durban, South Africa.

Disclosure: Honoraria for lectures and/or consultancies from abbVie, BMS, Gilead, Janssen, MSD, Roche, ViiV. Research grants from Dt. Leberstiftung, DZIF, NEAT ID.