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Goel A, Katiyar H, Mayank, Tiwari P, Rungta S, Verma A, Deep A, Sana A, Rai P, Aggarwal R. Hepatitis C Retreatment With First-Line Direct Acting Antiviral Drugs. J Clin Exp Hepatol 2023; 13:736-741. [PMID: 37693269 PMCID: PMC10482998 DOI: 10.1016/j.jceh.2023.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/17/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Aims Sofosbuvir (S), daclatasvir (D), ledipasvir, or velpatasvir (V) containing first-line hepatitis C virus (HCV) treatment regimens fail to cure viremia in 5-10%. We report our experience of HCV retreatment using these first-line drugs, in a setting where second-line anti-HCV drugs are not available. Methods Adults, who had relapsed after first complete course of a sofosbuvir-containing first-line, pegylated interferon free, anti-HCV treatment regimen with or without ribavirin (Riba) were included. Retreatment regimen, tailored to the failed anti-HCV regimen, was based on principle of using first-line drugs for 24 weeks with ribavirin and swapping between pangenotypic and genotype-specific regimens. Retreatment outcome was categorized as successful (achieved undetectable HCV RNA at the end of treatment [ETR] and sustained viral response at week 12 [SVR12]), non-responder (failed to achieve ETR), or relapse (achieved ETR but not achieved SVR12). Results Twelve patients (9 male; 7 cirrhosis; all genotype 3) who had relapsed to prior anti-HCV treatment (4 SD12, 4 SD24, 1 SDRiba12, 1 SDRiba24, 2 SV12) were included. Following retreatment (2 SDRiba24, 10 SVRiba24), all achieved ETR but only 9 (75%) achieved SVR12. Two among three, in whom retreatment failed, achieved SVR12 following another course of sofosbuvir/velpatasvir/ribavirin for 24 weeks. Overall, 11/12 (92%) patients achieved SVR12 following retreatment with the first-line anti-HCV drugs. Conclusion HCV retreatment could be a treatment option if second-line anti-HCV drugs are not available. Successful retreatment could be achieved, in a large proportion, with the use of first-line drugs for 24 weeks with ribavirin and swapping of pangenotypic/genotype-specific regimens (NCT03483987).
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Affiliation(s)
- Amit Goel
- Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Harshita Katiyar
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Mayank
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Prachi Tiwari
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sumit Rungta
- Department of Gastroenterology, King George's Medical University, Lucknow, India
| | - Abhai Verma
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amar Deep
- Department of Gastroenterology, King George's Medical University, Lucknow, India
| | - Asari Sana
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Praveer Rai
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Rakesh Aggarwal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Poizot-Martin I, Bellissant E, Garraffo R, Colson P, Piroth L, Solas C, Renault A, Bourlière M, Halfon P, Ghosn J, Alric L, Naqvi A, Carrieri P, Molina JM. Addition of boceprevir to PEG-interferon/ribavirin in HIV-HCV-Genotype-1-coinfected, treatment-experienced patients: efficacy, safety, and pharmacokinetics data from the ANRS HC27 study. HIV Clin Trials 2016; 17:63-71. [PMID: 27077673 DOI: 10.1080/15284336.2015.1135553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Scarce data exist on the efficacy and safety of the PEGylated-interferon/ribavirin/boceprevir regimen in HIV/HCV-coinfected patients who failed to respond to PEGylated-interferon/ribavirin treatment. OBJECTIVES To evaluate the efficacy and safety of this drug regimen and the impact of the addition of boceprevir(BOC) on atazanavir (ATV) or raltegravir (RAL) pharmacokinetic parameters in a subgroup of patients. METHODS In this single-arm phase 2 trial, HIV-1/HCV-genotype-1-coinfected patients received PEGylated-interferonα2b (1.5 μg/kg/week)+ ribavirin (800-1400 mg/day) alone until W4 and with BOC(800 mgTID) until W48. Based on virologic response at W8, the three drugs were stopped or PEGylated-interferon/ribavirin was continued alone until W72. The primary endpoint was SVR at W24 off-therapy (SVR24). RESULTS 64 patients were included. SVR24 was achieved in 53% of patients (CI90%: 43-63%) and in 90% of previous relapsers. In univariate analysis, SVR24 was associated with response to previous HCV treatment, HCV-1b subtype, HCV-RNA decline, ribavirin-Ctrough at W4, and HCV-RNA at W8 but not to fibrosis score, IL28B genotype, or boceprevir-Ctrough at W8. In multivariate analysis, SVR24 remained associated with response to previous HCV treatment [non-responders versus null responders: OR=5.0(1.3-20.0); relapsers vs. null responders: OR=28.8(4.9-169.5)]. HCV treatment was discontinued for adverse events in 17% of patients. A 51% decrease in ATV/r-AUC0-8 h (p<0.01) and a 57% increase in RAL-AUC0-8 h (p<0.01) were observed, although atazanavir/r or raltegravir did not affect BOC-AUC0-8 h significantly. The ATV mean Cthrough fell from 763.8 ng/mL (CI 95%: 230.3-1297.3) without BOC to 507.7 ng/mL (CI 95%: 164-851.4) with BOC. CONCLUSIONS Boceprevir-based regimen demonstrated a high SVR24 rate in treatment-experienced HIV-HCV genotype-1-coinfected relapsers.
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Affiliation(s)
- Isabelle Poizot-Martin
- a Aix-Marseille University, AP-HM Sainte-Marguerite, Service d'Immuno-Hématologie Clinique , Marseille , France.,b INSERM, UMR 912 (SESSTIM) , Marseille , France
| | - Eric Bellissant
- c Rennes 1 University, Pontchaillou University Hospital, Service de Pharmacologie , Rennes , France.,d INSERM, CIC 1414 Clinical Investigation Centre , Rennes , France
| | - Rodolphe Garraffo
- e Nice University, Pasteur University Hospital , Laboratoire de Pharmacologie et de Toxicologie Médicale , Nice , France
| | - Philippe Colson
- f Aix-Marseille University, AP-HM Timone, Fédération de Microbiologie Hospitalière , Marseille , France.,g URMITE , UM63, CNRS 7278, IRD 198, INSERM 1095, Marseille , France
| | - Lionel Piroth
- h Bourgogne University, Bocage University Hospital , Département d'Infectiologie , UMR 1347, Dijon , France
| | - Caroline Solas
- i Aix-Marseille University, AP-HM Timone, Service de Pharmacocinétique et Toxicologie , Marseille , France.,j INSERM , UMR 911 (CRO2), Marseille , France
| | - Alain Renault
- c Rennes 1 University, Pontchaillou University Hospital, Service de Pharmacologie , Rennes , France.,d INSERM, CIC 1414 Clinical Investigation Centre , Rennes , France
| | - Marc Bourlière
- k AP-HM Saint-Joseph, Service d'Hépato-Gastro-Entérologie , Marseille , France
| | | | - Jade Ghosn
- m Paris Descartes University , PRES Sorbonne Paris-Cité, EA 7327, Paris , France.,n Paris-Sud University, AP-HP Bicêtre Hospital, Service de Médecine Interne , Le Kremlin-Bicêtre, France
| | - Laurent Alric
- o Toulouse 3 University, Purpan University Hospital, Service de Médecine Interne , Toulouse , France
| | - Alissa Naqvi
- p Nice University, Archet University Hospital, Service d'Infectiologie , Nice , France
| | - Patrizia Carrieri
- b INSERM, UMR 912 (SESSTIM) , Marseille , France.,q ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille , France
| | - Jean-Michel Molina
- r Paris 7 - Denis Diderot University, AP-HP Saint-Louis Hospital, Service des Maladies Infectieuses et Tropicales , Paris , France
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Cotte L, Braun J, Lascoux-Combe C, Vincent C, Valantin MA, Sogni P, Lacombe K, Neau D, Aumaitre H, Batisse D, de Truchis P, Gervais A, Michelet C, Morlat P, Vittecoq D, Rosa I, Bertucci I, Chevaliez S, Aboulker JP, Molina JM, Aumaitre H, Batisse D, Bernard L, Cheret A, Cotte L, de Truchis P, Dellamonica P, Dominguez S, Gervais A, Girard PM, Lucht F, Metivier S, Michelet C, Molina JM, Morlat P, Neau D, Pageaux GP, Pol S, Rosa I, Rosenthal E, Vittecoq D, Valantin MA, Zucman D. Telaprevir for HIV/Hepatitis C Virus-Coinfected Patients Failing Treatment With Pegylated Interferon/Ribavirin (ANRS HC26 TelapreVIH): An Open-Label, Single-Arm, Phase 2 Trial. Clin Infect Dis 2014; 59:1768-76. [DOI: 10.1093/cid/ciu659] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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