title: Ledipasvir and sofosbuvir for HCV infection in patients coinfected with HBV.
abstract: Currently there are no all-oral treatment regimens for HCV in patients coinfected with HBV. In this pilot study, we evaluated whether ledipasvir and sofosbuvir therapy can suppress HCV infection in patients coinfected with HBV.
  
  
  
  Patients with HBV and genotype-1 HCV received 90 mg ledipasvir and 400 mg sofosbuvir daily for 12 weeks. The efficacy end point was sustained virological response (HCV RNA <15 IU/ml) 12 weeks after the end of treatment.
  
  
  
  Of the eight patients enrolled, six (75%) were male, five (63%) were Polynesian, seven (88%) had the CC IL28B genotype and two (25%) had cirrhosis. All eight patients (100%; 95% CI 63%, 100%) reached the primary end point of HCV RNA <15 IU/ml 12 weeks after treatment. In seven of eight patients (88%), serum HBV DNA levels increased during treatment, but none of the increases were greater than 20,000 IU/ml, and none were associated with clinical HBV flares or required treatment. The most common adverse events were viral infection (63%), fatigue (25%) and upper respiratory tract infection (25%). No patients had serious adverse events and none discontinued treatment for any reason.
  
  
  
  In this small sample, 12 weeks of ledipasvir/sofosbuvir was a safe and effective treatment for genotype-1 HCV infection in patients coinfected with HBV. Larger studies with longer follow-up are warranted.
authors.affiliation: Auckland Clinical Studies, Auckland, New Zealand.|New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Gane
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hyland
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, United States.
authors.forename: Di
authors.initials: D
authors.lastname: An
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, United States.
authors.forename: Evguenia S
authors.initials: ES
authors.lastname: Svarovskaia
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, United States.
authors.forename: Diana
authors.initials: D
authors.lastname: Brainard
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, United States.
authors.forename: John G
authors.initials: JG
authors.lastname: McHutchison
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D060085:Coinfection / Q000188:drug therapy*; D004279:DNA, Viral / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005449:Fluorenes / Q000008:administration & dosage* / Q000009:adverse effects; D006509:Hepatitis B / Q000188:drug therapy* / Q000821:virology; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000069474:Sofosbuvir / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000998:Antiviral Agents; D001562:Benzimidazoles; D004279:DNA, Viral; D005449:Fluorenes; C586541:ledipasvir; D000069474:Sofosbuvir