Low Risk of Failing Direct-Acting Antivirals in People With Human Immunodeficiency Virus/Hepatitis C Virus From Sub-Saharan Africa or Southeastern Asia: A European Cross-Sectional Study
Year: 2022
Type: article
Abstract: Background Several studies have reported suboptimal efficacy of direct-acting antivirals (DAAs) to treat hepatitis C virus (HCV) subtypes endemic to sub-Saharan Africa (SSA) and Southeastern Asia (SEA). The extent of this issue in individuals with human immunodeficiency virus (HIV)/HCV from SSA or SEA residing in Europe is unknown. Methods We retrospectively analyzed data from several prospective European cohorts of people living with HIV. We included individuals with HIV/HCV who originated from SSA or SEA, were treated with interferon-free DAAs, and had an available HCV RNA result ≥12 weeks after the end of treatment. The primary outcome was sustained virological response at least 12 weeks after the end of treatment (SVR12). Results Of the 3293 individuals with HIV/HCV treated with DAA and with available SVR12 data, 142 were from SSA (n = 64) and SEA (n = 78). SVR12 was achieved by 60 (94% [95% confidence interval {CI}, 86%–98%]) individuals from SSA and 76 (97% [95% CI, 92%–99%]) from SEA. The genotypes of the 6 individuals failing DAA treatment were 2, 3a, 3h, 4a, 4c, and 6j. For 2 of the 4 unsuccessfully treated individuals with available sequence data at treatment failure, NS5A resistance-associated substitutions were present (30R/93S in an individual with genotype 4c and 31M in an individual with genotype 6j). Conclusions SVR12 rates were high in individuals with HIV/HCV residing in Europe and originating from regions where intrinsically NS5A-resistant HCV strains are endemic. HCV elimination for this population in Europe is unlikely to be hampered by suboptimal DAA efficacy.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofac508
Authors: Cas Isfordink, Anders Boyd, Amanda Mocroft, Katharina Kusejko, Colette Smit, Stephane de Wit, Tabitha Mahungu, Karolin Falconer, Gilles Wandeler, Matthias Cavassini, Marcel Stöckle, Janke Schinkel, Andri Rauch, Lars Peters, Marc van der Valk, for EuroSIDA, the Swiss HIV Cohort Study, and the ATHENA Observational Cohort
Institutions: University Medical Center Utrecht, Amsterdam University Medical Centers, University of Amsterdam, Stichting HIV Monitoring, GGD Amsterdam, University of Copenhagen, Rigshospitalet, Centre of Excellence for Health, Immunity and Infections, University College London, University of Zurich, University Hospital Zurich, Université Libre de Bruxelles, Centre Hospitalier Universitaire de Saint-Pierre, Royal Free London NHS Foundation Trust, The Royal Free Hospital, Stockholm South General Hospital, University of Bern, University Hospital of Bern, Centre Hospitalier Universitaire Vaudois, University of Lausanne, University of Basel, University Hospital of Basel, Amsterdam UMC Location University of Amsterdam
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,676
Funders: National Science Foundation, Bristol-Myers Squibb, Pfizer, Gilead Sciences, ViiV Healthcare, Janssen Scientific Affairs, European Commission, National Research Foundation, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Danmarks Grundforskningsfond, Ministerie van Volksgezondheid, Welzijn en Sport, Stichting HIV Monitoring, Janssen Research and Development, Janssen Pharmaceuticals
Awards: G107059668, Swiss HIV Cohort Study, G2219656881, European Network of HIV/AIDS Cohort Studies to Coordinate at European and International Level Clinical Research on HIV/AIDS, G2596629253, G2947194344, G3578120429, Center for Personalized Medicine of Infectious Complications in Immune Deficiency (PERSIMUNE), G4305942465, G7672705757, G7791678565
OpenAlex ID: W4298124602