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Effectiveness and security of chronic hepatitis C treatment in coinfected patients in real-world

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Abstract

Background HIV–HCV coinfection produces high morbi-mortality. Direct-acting antivirals (DAAs) have shown high efficacy, although special attention should be paid to the risk of drug interactions. However, due to the lack of representativeness of coinfected patients in clinical trials, it is important to know real-world results. Objective To evaluate DAA treatment effectiveness in coinfected patients. We also analyse safety profile of DAA treatment and drug interactions between HCV and HIV therapy. Setting Descriptive study carried in a tertiary hospital of Spain Method HIV–HCV coinfected patients treated with DAAs between November 2014 and June 2016 were included. Main outcome measure Efficacy was measured in terms of sustained virologic response at week 12 after the end of therapy. Adverse events that led to treatment discontinuation were registered to evaluate the safety profile, and also drug interactions between DAAs and antiretroviral treatment were evaluated. Results Main HCV genotypes were 1a (34.9%) and 4 (24.5%). 51.9% were HCV previously treated, 54.7% had grade 4 liver fibrosis. SVR12 was reported in 90.6%. HCV treatment was well tolerated and there were no discontinuations because of adverse events. 30.2% of HIV treatments had to be modified before DAA treatment was started due to interactions, HIV suppression was not compromised. Conclusion DAA treatment in coinfected patients seems to be highly effective and secure. Evaluation of drug interactions must be a priority in order to maximize effectiveness and avoid toxicity.

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Funding

This study did not receive special funding.

Conflicts of interest

All the authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Pharmacy Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Saragossa, Spain

    Moisés Uriarte-Pinto, Herminia Navarro-Aznarez, Natalia De La Llama-Celis & María Reyes Abad-Sazatornil

  2. Unit of Infectious Diseases, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Saragossa, Spain

    Piedad Arazo-Garcés

  3. Microbiology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009, Saragossa, Spain

    Ana María Martínez-Sapiña

Authors
  1. Moisés Uriarte-Pinto
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  2. Herminia Navarro-Aznarez
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Correspondence to Moisés Uriarte-Pinto.

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Uriarte-Pinto, M., Navarro-Aznarez, H., De La Llama-Celis, N. et al. Effectiveness and security of chronic hepatitis C treatment in coinfected patients in real-world. Int J Clin Pharm 40, 608–616 (2018). https://doi.org/10.1007/s11096-018-0621-0

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  • DOI: https://doi.org/10.1007/s11096-018-0621-0

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