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Dual treatment of acute HCV infection in HIV co-infection: influence of HCV genotype upon treatment outcome

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Abstract

Purpose

With DAAs still only being licensed for chronic HCV infection, the ongoing epidemic of acute hepatitis C (AHC) infection among MSM highlights the need to identify factors allowing for optimal HCV treatment outcome.

Methods

303 HIV-infected patients from 4 European countries with diagnosed acute HCV infection were treated early with pegylated interferon (pegIFN) and ribavirin (RBV) (n = 273) or pegylated interferon alone (n = 30).

Results

All patients were male, median age was 39 years. Main routes of transmission were MSM (95 %) and IVDU (3 %). 69 % of patients were infected with HCV GT 1, 4.3 % with GT 2, 10.6 % with GT 3, 16.1 % with GT 4. Overall SVR rate was 69.3 % (210/303). RVR (p ≤ 0.001), 48-w treatment duration (p ≤ 0.001) and GT 2/3 (p = 0.024) were significantly associated with SVR. SVR rates were significantly higher in HCV GT 2/3 receiving pegIFN and RBV (33/35) when compared with pegIFN mono-therapy (6/10) (94 % vs. 60 % respectively; p = 0.016). In multivariate analysis, pegIFN/RBV combination therapy (p = 0.017) and rapid virological response (RVR) (p = 0.022) were significantly associated with SVR in HCV GT 2/3. In HCV GT 1/4, RVR (p ≤ 0.001) and 48-w treatment duration (p ≤ 0.001) were significantly associated with SVR.

Conclusions

Treatment of AHC GT 2 and 3 infections with pegIFN/RBV is associated with higher SVR rates suggesting different cure rates depending on HCV genotype similar to the genotype effects seen previously in chronic HCV under pegIFN/RBV. With pegIFN/RBV still being the gold standard of AHC treatment and in light of cost issues around DAAs and very limited licensed interferon-free DAA treatment options for chronic HCV GT 3 infection AHC GT 3 patients might benefit most from early interferon-containing treatment.

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Acknowledgments

We thank JR Bogner (Munich), A Carganico (Berlin), C Cordes (Berlin), S Dupke (Berlin), G Fätkenheuer (Cologne), S Fenske (Hamburg), M Freiwald (Berlin), J Gölz (Berlin), B Hintsche (Berlin), C Hoffmann (Hamburg), AB Jessen (Berlin), H Jessen (Berlin), P Kokordelis (Bonn), T Kümmerle (Cologne), I Leistner (Berlin), C Mayr (Berlin), A Moll (Berlin), A Mutz (Osnabrück), J Nattermann (Bonn), B Payer (Vienna), M Peck-Radosavljevic (Vienna), N Qurishi (Cologne), M Rausch (Berlin), K Schewe (Hamburg), C Schwarze-Zander (Bonn), T Seidel (Jena), U Seybold (Munich), U Spengler (Bonn), LD Stein (Berlin), A Theisen (Cologne), A Trein (Stuttgart), K Ummard (Berlin), JC Wasmuth (Bonn), W Wiesel (Cologne) and C Wyen (Cologne) for their continued support and dedication to the study.

Author information

Authors and Affiliations

  1. Department of Medicine I, Bonn University Hospital, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    Christoph Boesecke, Martin Vogel & Jürgen K. Rockstroh

  2. MiB, Berlin, Germany

    Patrick Ingiliz & Axel Baumgarten

  3. Medical University of Vienna, Vienna, Austria

    Thomas Reiberger

  4. Infektionsmedizinisches Centrum Hamburg (ICH), Hamburg, Germany

    Hans-Jürgen Stellbrink

  5. Royal Free Hospital, London, UK

    Sanjay Bhagani

  6. Chelsea and Westminster Hospital, London, UK

    Emma Page & Mark Nelson

  7. Center for HIV and Hepatogastroenterology, Düsseldorf, Germany

    Stefan Mauss

  8. Infektiologikum, Frankfurt/Main, Germany

    Thomas Lutz

  9. Praxis Ebertplatz, Cologne, Germany

    Esther Voigt

  10. Inserm U943, UPMC-Paris06 UMR S943, Paris, France

    Marguerite Guiguet

  11. AP-HP, Hôpital La Pitié Salpétrière, Paris, France

    Marc-Antoine Valantin

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  1. Christoph Boesecke
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Corresponding author

Correspondence to Christoph Boesecke.

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Conflict of interest

CB has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck, Roche and ViiV. PI has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck, ViiV, Pfizer, Janssen and Tibotec. SM has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck and Roche. AB has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck, Vertex, Novartis, ViiV, Pfizer, Bionor, Janssen and Tibotec. MN has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck, ViiV, Pfizer and Janssen. JKR has received honoraria for consulting or educational lectures from Abbott, Boehringer, Gilead, Merck, Vertex, Novartis, ViiV, Pfizer, Bionor, Janssen and Tibotec.

Funding

This work was in part funded by the European AIDS Treatment Network (NEAT). NEAT is a project funded by the European Union under the 6th Framework programme, contract acronym: NEAT, number: LSHP-CT-2006-037570.

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Boesecke, C., Ingiliz, P., Reiberger, T. et al. Dual treatment of acute HCV infection in HIV co-infection: influence of HCV genotype upon treatment outcome. Infection 44, 93–101 (2016). https://doi.org/10.1007/s15010-015-0856-9

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  • DOI: https://doi.org/10.1007/s15010-015-0856-9

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