title: Efficacy of sofosbuvir-based therapies in HIV/HCV infected patients and persons who inject drugs.
abstract: In the era of Directly Acting anti HCV Antivirals treatment of hepatitis C is successful in the majority of persons treated. However, treatment of persons with HIV or who inject drugs remains challenging because of special issues: drug-drug interactions with antiretroviral, psychiatric and drug substitution therapies, treatment adherence, impact of treatment on HIV disease course or on risk of bacterial infections. Sofosbuvir induced sustained virologic response in 91% of 23 HIV/HCV coinfected persons treated in combination with ribavirin and pegylated interferon, in 83% of 497 treated in combination with ribavirin and in all 50 patients infected with HCV GT1 treated in combination with ledipasvir and ribavirin. The rates of efficacy in HCV-HIV coinfected were almost the same as those observed in HCV monoinfected suggesting that the efficacy of sofosbuvir is not reduced by HIV coinfection. There are no data on the efficacy of sofosbuvir in injection drugs users. The pangenotypic activity, the high barrier to resistance, the modest potential for drug-drug interactions makes sofosbuvir a reference drug for the treatment of these two special populations.
authors.affiliation: Division of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy. Electronic address: massimo.puoti@ospedaleniguarda.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Puoti
authors.affiliation: Division of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Panzeri
authors.affiliation: Division of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rossotti
authors.affiliation: Division of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Baiguera
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy / Q000821:virology; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000069474:Sofosbuvir; D015819:Substance Abuse, Intravenous / Q000821:virology*; D014542:Uridine Monophosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: Hepatitis C virus; Human immune deficiency virus; Injection drugs users; Sofosbuvir