Abstract # THU-250 Treatment of “acute” hepatitis C virus in human immunodeficiency virus-infected men with short-course sofosbuvir/ledipasvir—D. S. Fierer et al.
Study Aims and Results
Prior studies to treat acute hepatitis C in people with HIV for 6 weeks with Harvoni (sofosbuvir/ledipsavir) did not achieve favorable results. The aim of this study was to find out if extending the treatment period to 8 weeks improved the cure rates. The inclusion criteria was elevated ALT levels (liver enzymes), documented recent exposure to the hepatitis C virus (HCV antibody and HCV RNA (viral load)) or re-infection after a spontaneous, natural clearance or treatment cure.
Twenty-six HIV positive men who acquired hepatitis C from sexual contact (21 primary infection; 5 re-infection) were enrolled in the study between August 2014 and March 2016. Active drug use was common during this period—mostly methamphetamines. Five men had spontaneous clearance during this period before treatment could be started. The characteristics of the remaining 21 people treated was a median age of 37 yo; 14 (58%) black or Hispanic, twenty (95%) were genotype 1 and one person was a genotype 4.
Treatment was started at a medium of 18 weeks after a diagnosis of acute hepatitis C. Nineteen men received 8 weeks of treatment, one received 6 weeks and one was extended to 12 weeks.
All of the men who were treated were cured. The authors commented that a better understanding of the best timeline to treat acute hepatitis C in people infected with HIV.
A meta-analysis review of acute HCV in people with HIV would be helpful. This will narrow down the optimal timeframe to treat. Still, the cure rates are very encouraging!
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