Last update:
07-Nov-2019

OBJECTIVE To investigate the effectiveness of direct acting antiviral drugs (DAAs) in HIV/HCV co-infected patients and to document treatment-associated problems.

METHOD All HIV/HCV co-infected patients attending the HIV unit of the "Laiko" University Hospital in Athens, Greece, from 1.1.2015 to 31.12.2017 were screened for this study. Inclusion criteria were HIV/HCV co-infection and age 18–85 years. A diagnosis of poor prognosis cancer was an exclusion criterion. Transient elastography (TE) was performed at study entry and laboratory tests were conducted at baseline and every 3 months until the end of follow up. HCV treatment was administered according to national guidelines. All the patients were followed up for 6 months after sustained virological response (SVR) and treatment-related and HIV-related complications were noted.

RESULTS A total of 28 patients with HIV/HCV coinfection were treated during the study period, 25 of which were male. Abnormal serum levels of transaminases were recorded in 21 patients at study entry. The median TE value was 7.6 kilopaskal (KPa), with 11 patients being classified as Metavir F0–F1 fibrosis, 6 F2, 8 F3 and 3 F4 according to TE. Thirteen patients had HCV genotype 1, 7 genotype 3, 4 genotype 2 and 4 genotype 4. Stage C HIV infection according to CDC staging was identified in 5 patients. SVR for HCV infection was achieved in 26 of the 28 patients treated (93%). Before the initiation of DAAs, 9 patients required a change in HIV-antiretroviral treatment (ARV), due to drug-drug interactions. No patient had a worsening of HIV-related serum markers during HCV-treatment and follow up.

CONCLUSIONS DAAs treatment in HIV/HCV co-infected patients results in high SVR rates, with no significant side effects. ARV modification, when needed, allows HCV eradication with no adverse HIV-related effects.

Key words: Direct-acting antiviral drugs (DAA), HCV, HCV/HIV coinfection, HIV.