Potential for Drug-Drug Interactions between Antiretrovirals and HCV Direct Acting Antivirals in a Large Cohort of HIV/HCV Coinfected Patients.
OBJECTIVE
Development of direct acting antivirals (DAA) offers new benefits for patients with chronic hepatitis C. The combination of these drugs with antiretroviral treatment (cART) is a real challenge in HIV/HCV coinfected patients. The aim of this study was to describe potential drug-drug interactions between DAAs and antiretroviral drugs in a cohort of HIV/HCV coinfected patients.


METHODS
Cross-sectional study of all HIV/HCV coinfected patients attending at least one visit in 2012 in the multicenter French Dat'AIDS cohort. A simulation of drug-drug interactions between antiretroviral treatment and DAAs available in 2015 was performed.


RESULTS
Of 16,634 HIV-infected patients, 2,511 had detectable anti-HCV antibodies, of whom 1,196 had a detectable HCV-RNA and were not receiving HCV treatment at the time of analysis. 97.1% of these patients were receiving cART and 81.2% had a plasma HIV RNA <50 copies/mL. cART included combinations of nucleoside reverse transcriptase inhibitors with a boosted protease inhibitor in 43.6%, a non-nucleoside reverse transcriptase inhibitor in 17.3%, an integrase inhibitor in 15.4% and various combinations or antiretroviral drugs in 23.7% of patients. A previous treatment against HCV had been administered in 64.4% of patients. Contraindicated associations/potential interactions were expected between cART and respectively sofosbuvir (0.2%/0%), sofosbuvir/ledipasvir (0.2%/67.6%), daclatasvir (0%/49.4%), ombitasvir/boosted paritaprevir (with or without dasabuvir) (34.4%/52.2%) and simeprevir (78.8%/0%).


CONCLUSIONS
Significant potential drug-drug interactions are expected between cART and the currently available DAAs in the majority of HIV/HCV coinfected patients. Sofosbuvir/ledipasvir and sofosbuvir/daclatasvir with or without ribavirin appeared the most suitable combinations in our population. A close collaboration between hepatologists and HIV/AIDS specialists appears necessary for the management of HCV treatment concomitantly to cART.
Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic, Marseille, France; Inserm U912 (SESSTIM), Marseille, France.
Isabelle
I
Poizot-Martin
CHU de Nice, Hôpital Archet 1, Service de Maladies Infectieuses, Unité de Virologie Clinique, Nice, France.
Alissa
A
Naqvi
Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic, Marseille, France.
Véronique
V
Obry-Roguet
Sorbonne Universités, UPMC Université Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France; APHP, Groupe hospitalier Pitié-Salpêtrière-Université Pierre et Marie Curie, Service de Maladies Infectieuses et Tropicales, Paris, France.
Marc-Antoine
MA
Valantin
INSERM, UMR 1027, Toulouse, F-31000, France; Université de Toulouse III, Toulouse, F-31000, France; CHU Toulouse, COREVIH Toulouse, F-31000, France.
Lise
L
Cuzin
Service des maladies infectieuses, CHU, Hôtel-Dieu, Nantes, France.
Eric
E
Billaud
Centre Hospitalier de Tourcoing, Service Universitaire de Maladies Infectieuses, Tourcoing, France; CHU Bicêtre, Service de Médecine Interne, Le Kremlin-Bicêtre, France; Laboratoire de Virologie, Hôpital Necker EA 7327 Université Paris Descartes, Paris, France.
Antoine
A
Cheret
Hôpitaux Universitaires de Strasbourg, Center for HIV care, Strasbourg, France.
David
D
Rey
CHU Clermont-Ferrand, Service des Maladies Infectieuses et tropicales, Clermont-Ferrand, France.
Christine
C
Jacomet
Laboratoire de Virologie, Hôpital Necker EA 7327 Université Paris Descartes, Paris, France; APHP-Hopital Necker, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur IHU Imagine, Paris, France; Institut Pasteur, Centre Médical-Centre d'Infectiologie Necker-Pasteur, Paris, France.
Claudine
C
Duvivier
CHU de Nice, Hôpital Archet 1, Service de Maladies Infectieuses, Unité de Virologie Clinique, Nice, France.
Pascal
P
Pugliese
Hospices civils de Lyon, Hôpital de la Croix Rousse, Service d'Hépatologie, Centre de recherche clinique, Lyon, France; Inserm U1052, Lyon, France.
Pierre
P
Pradat
Inserm U1052, Lyon, France; Hospices civils de Lyon, Hôpital de la Croix Rousse, Service des maladies infectieuses, Lyon, France.
Laurent
L
Cotte
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004347:Drug Interactions / Q000502:physiology*; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D016174:Hepacivirus / Q000187:drug effects*; D018937:Hepatitis C Antibodies; D019698:Hepatitis C, Chronic / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011480:Protease Inhibitors / Q000627:therapeutic use
D019380:Anti-HIV Agents; D018937:Hepatitis C Antibodies; D011480:Protease Inhibitors