title: HCV viral load at baseline and at week 4 of telaprevir/boceprevir based triple therapies are associated with virological outcome in HIV/hepatitis C co-infected patients.
abstract: BACKGROUND
  As first generation HCV-specific protease inhibitors, boceprevir (BOC) or telaprevir (TVR) can achieve 60% to 70% sustained virological response (SVR) for HCV infected patients with genotype 1 infections, they could remain temporary a therapeutic option in patients living in resources limited countries with limited access to the new anti-HCV direct acting antiviral (DAA) drugs, such as sofosbuvir.
  
  
  OBJECTIVE
  Here we evaluated in a routine practice setting, the treatment responses, tolerance and factors associated with SVR of a triple therapy with BOC or TVR, combined with pegylated interferon and ribavirin (PegIFN/RBV) in HIV/HCV co-infected patients, included in a large cohort of HIV/HCV coinfected patients (ANRS CO13-HEPAVIH).
  
  
  RESULTS
  Among the 89 HIV/HCV coinfected patients treated, 65% of whom were previous non-responders to PegIFN/RBV therapy, 65%, 55% and 41% had at baseline genotype 1a, a high baseline HCV-RNA (≥800,000 IU/ml) and a cirrhosis, respectively. The SVR12 rate was 63% overall, 53% for BOC-based regimen and 66% for TVR-based regimen. In multivariate analysis, two factors were significantly associated with HCV SVR: HCV viral load <800,000 IU/mL at treatment initiation versus ≥800,000 IU/mL (OR 4.403, 95% CI 1.29-15.04; p=0.018) and virological response at W4 (HCV-RNA undetectable after 4 weeks of triple therapy) (OR 3.35, 95% CI 1.07-10.48; p=0.038).
  
  
  CONCLUSIONS
  Overall SVR12 was 63% and our results suggest that HIV/HCV coinfected patients with low HCV viral load (<800,000 IU/mL) and undetectable HCV-RNA after 4 weeks of triple therapy with TVR or BOC-based regimen have a higher probability of treatment success.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP-Université Paris Descartes, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Salmon
authors.affiliation: Service des Maladies Infectieuses et Tropicales, CHU Reims, Université Champagne Ardenne, Reims, France. Electronic address: fbanisadr@chu-reims.fr.
authors.forename: F
authors.initials: F
authors.lastname: Bani-Sadr
authors.affiliation: INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Gilbert
authors.affiliation: Service de Médecine Interne, Hôpital de l'Archet, Nice, France.
authors.forename: E
authors.initials: E
authors.lastname: Rosenthal
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Pitié Salpêtrière-APHP, Paris, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Valantin
authors.affiliation: Service de Médecine Interne, Hôpital Pitié Salpêtrière-APHP, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Simon
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Neau
authors.affiliation: Service de Médecine Interne et Maladies Infectieuses, CHU de Bordeaux, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Morlat
authors.affiliation: INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Loko
authors.affiliation: INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Wittkop
authors.affiliation: INSERM, ISPED, Center INSERM U897-Epidémiologie-Biostatistiques, F-33000 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Dabis
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000494:pharmacology; D060085:Coinfection / Q000188:drug therapy / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology*; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage* / Q000494:pharmacology; D011392:Proline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D012254:Ribavirin / Q000008:administration & dosage / Q000494:pharmacology; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D007372:Interferons; D011392:Proline
keywords: Boceprevir; HCV protease inhibitors; HCV sustained virologic response; HCV undetectable viral load; HIV/HCV-coinfection; Low HCV viral load; SVR; Telaprevir