All-oral Direct-acting Antiviral Regimens in HIV/Hepatitis C Virus–coinfected Patients With Cirrhosis Are Efficient and Safe: Real-life Results From the Prospective ANRS CO13–HEPAVIH Cohort - Université de Nantes Accéder directement au contenu
Article Dans Une Revue Clinical Infectious Diseases Année : 2016

All-oral Direct-acting Antiviral Regimens in HIV/Hepatitis C Virus–coinfected Patients With Cirrhosis Are Efficient and Safe: Real-life Results From the Prospective ANRS CO13–HEPAVIH Cohort

1 Service d'hépatologie médicale [CHU Cochin]
2 Dynamiques des Réponses immunes - Dynamics of Immune Responses
3 UPD5 - Université Paris Descartes - Paris 5
4 BPH - Bordeaux population health
5 CHU Saint-Antoine [AP-HP]
6 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
7 Département d'infectiologie (CHU de Dijon)
8 UB - Université de Bourgogne
9 UNS - Université Nice Sophia Antipolis (1965 - 2019)
10 Hôpital l'Archet
11 Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL]
12 Service des maladies infectieuses et tropicales
13 Epidémiologie et Biostatistique [Bordeaux]
14 ISPED - Institut de Santé Publique, d'Epidémiologie et de Développement
15 CHU Tenon [AP-HP]
16 Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM]
17 Service d'immunologie clinique [Créteil]
18 CHU Pitié-Salpêtrière [AP-HP]
19 Service de médecine interne et maladies infectieuses [Bordeaux]
20 UB - Université de Bordeaux
21 Service des Maladies Infectieuses et Tropicales A [Bordeaux]
22 Hôpital Foch [Suresnes]
23 Service des maladies infectieuses et tropicales
24 UP13 - Université Paris 13
25 Service de maladies infectieuses et tropicales [Saint-Louis]
26 Hôpital universitaire Robert Debré [Reims]
27 URCA - Université de Reims Champagne-Ardenne
28 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
29 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
30 Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre]
31 Service de médecine interne et maladies infectieuses
32 Service de maladies infectieuses et tropicales [Nantes]
33 Centre Hospitalier Saint Jean de Perpignan
34 Service de médecine interne, immunologie clinique [Béclère]
35 Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Julie Chas
  • Fonction : Auteur
David Zucman

Résumé

BACKGROUND: Human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients with cirrhosis have long been considered to be difficult to treat, and real-life efficacy and tolerance data with all-oral direct-acting antiviral (DAA) combinations in these patients are scarce. METHODS: Cirrhotic HIV/HCV-coinfected patients enrolled in the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) CO13 HEPAVIH cohort initiating an all-oral DAA regimen were consecutively included. A negative HCV RNA result at 12 weeks of follow-up or thereafter was assumed as a sustained virologic response (SVR12). Adjusted exact logistic regression was used to study factors associated with treatment outcome. RESULTS: We included 189 patients who initiated an all-oral DAA regimen with the following characteristics: median age 53.2 years; 74.6% male; Centers for Disease Control and Prevention classification A/B/C: 37%/31%/32%; Child-Pugh class A/B/C: 91%/8%/1%; 87% with HIV RNA <50 copies/mL; 99% on antiretrovirals; median CD4 count: 489 cells/µL; HCV treatment naive 29%; HCV genotype 1/2/3/4: 58%/4%/17%/21%. Sofosbuvir (SOF) + daclatasvir ± ribavirin (RBV) was used in 123 patients, SOF + RBV in 30, SOF + simeprevir in 11, and SOF + ledipasvir in 23. An SVR12 was reported in 93.1% of the patients (95% confidence interval, 88.5%-96.3%). In adjusted analyses, no difference was found between 12 or 24 weeks of treatment, in patients receiving RBV or not, and in treatment-naive vs experienced patients. Premature stop of DAA was reported for 8 patients. One patient died during treatment (unknown cause), and 12 other patients developed liver-related events. CONCLUSIONS: In this prospective real-life cohort, all-oral DAA regimens were well tolerated and associated with a high virologic efficacy in cirrhotic HIV/HCV-coinfected patients. This should not alleviate the surveillance for liver-related events in these patients.
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Dates et versions

inserm-01993207 , version 1 (24-01-2019)

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Philippe Sogni, Camille Gilbert, Karine Lacombe, Lionel Piroth, Eric Rosenthal, et al.. All-oral Direct-acting Antiviral Regimens in HIV/Hepatitis C Virus–coinfected Patients With Cirrhosis Are Efficient and Safe: Real-life Results From the Prospective ANRS CO13–HEPAVIH Cohort. Clinical Infectious Diseases, 2016, 63 (6), pp.763-770. ⟨10.1093/cid/ciw379⟩. ⟨inserm-01993207⟩
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