Arends J E, van der Meer J T M, Posthouwer D, Kortmann W, Brinkman K, van Assen S, Smit C, van der Valk M, van der Ende M, Schinkel J, Reiss P, Richter C, Hoepelman A I M
Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
Neth J Med. 2015 Aug;73(7):324-30.
Recent publications have reported superior efficacy of telaprevir- or boceprevir-based triple therapy over conventional peginterferon-alfa/ribavirin therapy, albeit with varying rates of adverse events and treatment discontinuations in HIV/HCV coinfected patients. Therefore, the aim of this study is to describe the effectiveness of triple therapy in an HIV/HCV coinfection cohort in the Netherlands.
HIV-infected patients with chronic HCV genotype 1 starting triple therapy including either boceprevir or telaprevir were enrolled, 26% had F3-F4 fibrosis. Data were assessed at Week 4, 8, 12, 24, 48 and SVR12 (i.e. absence of detectable plasma HCV RNA 12 weeks after completion of treatment). Failure was defined as discontinuation of treatment due to virological failure, adverse events or loss to follow-up.
A total of 53 HIV/HCV coinfected patients started peginterferon-alfa/ribavirin therapy with either boceprevir (n = 29) or telaprevir (n = 24). SVR12 was achieved in 19 (66%) of the boceprevir-treated and 15 (63%) of the telaprevir-treated patients. Both prior relapse and achievement of a rapid virological response were associated with a higher SVR12 rate. Non- response, breakthrough and relapse occurred in 4, 1 and 5 patients on boceprevir and 3, 2, 2 on telaprevir, respectively. One patient was lost to follow-up and one patient died due to progression of liver failure. Except for these two patients, no treatment discontinuations were observed due to adverse events.
In HIV/HCV coinfected patients, boceprevir or telaprevir triple therapy was well tolerated and resulted in favourable SVR12 rates comparable with previous publications concerning HCV mono-infected patients.
近期的出版物报道了基于替拉普韦或博赛泼维的三联疗法相较于传统聚乙二醇干扰素-α/利巴韦林疗法具有更高的疗效，尽管在HIV/HCV合并感染患者中不良事件发生率和治疗中断率各不相同。因此，本研究的目的是描述三联疗法在荷兰HIV/HCV合并感染队列中的有效性。
纳入开始接受包括博赛泼维或替拉普韦的三联疗法的慢性丙型肝炎1型HIV感染患者，26%有F3 - F4纤维化。在第4、8、12、24、48周和SVR12（即治疗完成后12周血浆HCV RNA检测不到）时评估数据。治疗失败定义为因病毒学失败、不良事件或失访而停止治疗。
共有53例HIV/HCV合并感染患者开始接受聚乙二醇干扰素-α/利巴韦林联合博赛泼维（n = 29）或替拉普韦（n = 24）的治疗。接受博赛泼维治疗的患者中有19例（66%）实现了SVR12，接受替拉普韦治疗的患者中有15例（63%）实现了SVR12。既往复发和快速病毒学应答的实现均与更高的SVR12率相关。接受博赛泼维治疗的患者中分别有4例、1例和5例出现无应答、突破和复发，接受替拉普韦治疗的患者中分别有3例、2例和2例出现无应答、突破和复发。1例患者失访，1例患者因肝功能衰竭进展死亡。除这两名患者外，未观察到因不良事件而停止治疗的情况。
在HIV/HCV合并感染患者中，博赛泼维或替拉普韦三联疗法耐受性良好，SVR12率良好，与先前关于HCV单感染患者的出版物相当。
