Telaprevir in the treatment of acute hepatitis c virus infection in HIV-infected men

Daniel S. Fierer, Douglas T. Dieterich, Michael P. Mullen, Andrea D. Branch, Alison J. Uriel, Damaris C. Carriero, Wouter O. Van Seggelen, Rosanne M. Hijdra, David G. Cassagnol, Bisher Akil, Juan Bailey, Paul Bellman, Daniel Bowers, Krisczar Bungay, Susanne Burger, Ward Carpenter, Robert Chavez, Rita Chow, Robert Cohen, Patrick DaltonJohn Dellosso, Adrian Demidont, Stephen Dillon, Eileen Donlon, Terry Farrow, Donald Gardenier, Rodolfo Guadron, Stuart Haber, Lawrence Higgins, Lawrence Hitzeman, Ricky Hsu, Shirish Huprikar, Victor Inada, Sneha Jacob, Livette Johnson, Barbara Johnston, Donald Kaminsky, Oscar Klein, Jeffrey Kwong, Jose Lares-Guia, Eric Leach, Randy Levine, Irina Linetskaya, Larisa Litvinova, Amisha Malhotra, William Mandell, Martin Markowitz, Gal Mayer, Eddie Meraz, Erik Mortensen, Michel Ng, Joseph Olivieri, Charles Paolino, Punyadech Photangtham, George Psevdos, Anita Radix, Steven Rapaport, Gabriela Rodriguez-Caprio, William Shay, Nirupama Somasundaram, Lembitu Sorra, Alicia Stivala, Richie Tran, Antonio Urbina, Rona Vail, Francis Wallach, Wen Wang, Susan Weiss, Melissa Wiener

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Background. There is an international epidemic of hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-infected men who have sex with men. Sustained virologic response (SVR) rates with pegylated interferon and ribavirin treatment are higher in these men during acute HCV than during chronic HCV, but treatment is still lengthy and SVR rates are suboptimal.Methods. We performed a pilot study of combination therapy with telaprevir, pegylated interferon, and ribavirin in acute genotype 1 HCV infection in HIV-infected men. Men who were treated prior to the availability of, or ineligible for, telaprevir were the comparator group. The primary endpoint was SVR12, defined as an HCV viral load <5 IU/mL at least 12 weeks after completing treatment.Results. In the telaprevir group, 84% (16/19) of men achieved SVR12 vs 63% (30/48) in the comparator group. Among men with SVR, median time to undetectable viral load was week 2 in the telaprevir group vs week 4 in the comparator group, and 94% vs 53% had undetectable viral loads at week 4. Most patients (81%) who achieved SVR in the telaprevir group received ≤12 weeks of treatment and there were no relapses after treatment. The overall safety profile was similar to that known for telaprevir-based regimens.Conclusions. Incorporating telaprevir into treatment of acute genotype 1 HCV in HIV-infected men halved the treatment duration and increased the SVR rate. Larger studies should be done to confirm these findings. Clinicians should be alert to detect acute HCV infection of HIV-infected men to take advantage of this effective therapy and decrease further transmission in this epidemic.

Original languageEnglish
Pages (from-to)873-879
Number of pages7
JournalClinical Infectious Diseases
Volume58
Issue number6
DOIs
StatePublished - Mar 2014

Keywords

  • HIV infection
  • acute HCV
  • men who have sex with men
  • telaprevir
  • treatment

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