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Successful treatment of three patients with human immunodeficiency virus and hepatitis C virus genotype 1b co-infection by daclatasvir plus asunaprevir

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Abstract

Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) often accelerates the course of HCV-associated liver disease. Daclatasvir (DCV) plus asunaprevir (ASV) have been shown to be highly effective for HCV-infected patients with genotype 1b. Three patients co-infected with HIV/HCV genotype 1b were enrolled in this study. Prior to initiation of HCV treatment, the variants associated with L31 and Y93 in the non-structural protein 5A (NS5A) region of the HCV genome were confirmed to be absent using a direct sequencing method. Taking into consideration the lower risk of drug–drug interaction and the need for immediate treatment, the patients received 60 mg DCV once daily plus 100 mg ASV twice daily for 24 weeks. In one patient, the alanine aminotransferase level was elevated to 228 IU/L at 24 weeks after the start of treatment, but he completed the 24-week treatment course. All three patients achieved sustained viral response, without severe complications (including HIV virological rebound). Thus, in cases where NS5A variants are confirmed to be absent and patients are antiretroviral therapy-naïve, with CD4+ over 500/μL or HIV well controlled by RAL-based cART, DCV plus ASV may represent a good treatment option for HIV and HCV genotype 1b co-infected patients.

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Acknowledgments

This research was supported in part by funding from the Research Program on Hepatitis and Research Program on HIV/AIDS from the Japan Agency for Medical Research and Development, AMED.

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Authors and Affiliations

  1. Department of Gastroenterology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Noboru Hirashima, Hiroaki Iwase, Masaaki Shimada & Nobumitsu Ryuge

  2. Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Junji Imamura, Yoshiyuki Yokomaku & Tsunamasa Watanabe

  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, 216-8511, Japan

    Hiroki Ikeda, Nobuyuki Matsumoto, Chiaki Okuse, Fumio Itoh & Tsunamasa Watanabe

  4. Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Yasuhito Tanaka

Authors
  1. Noboru Hirashima
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  2. Hiroaki Iwase
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  3. Masaaki Shimada
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Corresponding author

Correspondence to Tsunamasa Watanabe.

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Conflict of Interest:

Noboru Hirashima, Hiroaki Iwase, Masaaki Shimada, Nobumitsu Ryuge, Junji Imamura, Hiroki Ikeda, Yasuhito Tanaka, Nobuyuki Matsumoto, Chiaki Okuse, Fumio Itoh, Yoshiyuki Yokomaku and Tsunamasa Watanabe declare that they have no conflict of interest.

Human Rights:

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent:

Informed consent was obtained from all patients for inclusion in the study.

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Hirashima, N., Iwase, H., Shimada, M. et al. Successful treatment of three patients with human immunodeficiency virus and hepatitis C virus genotype 1b co-infection by daclatasvir plus asunaprevir. Clin J Gastroenterol 10, 41–46 (2017). https://doi.org/10.1007/s12328-016-0693-0

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  • DOI: https://doi.org/10.1007/s12328-016-0693-0

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