HIV/HCV therapy with ledipasvir/sofosbuvir after randomized switch to emtricitabine-tenofovir alafenamide-based single-tablet regimens

Abstract

Introduction Guidelines advocate the treatment of HCV in all HIV/HCV co-infected individuals. The aim of this randomized, open-label study (ClinicalTrials.

Sustained virological response after treatment with direct‐acting antivirals can help immune reconstitution in HIV‐HCV coinfected patients even in case of persistent HIV low‐level viremia

“…The lower levels of T‐cell activation described in patients with undetectable plasma HIV viremia with respect to those with detectable plasma HIV‐RNA 16 could be the basis for the second main result of our study; about half the subjects with RV achieved HIV‐RNA undetectability at SVR12. We could report these data because our study design distinguished patients with detectable plasma HIV viremia (even at low copy number) and those with a negative result, differently from previously published works, including HIV‐HCV patients successfully treated with DAA, that define HIV suppression as having a plasma HIV‐RNA lower than 50 copies/mL 17,18 . The percentage of subjects who achieved complete HIV viremia suppression was higher than that observed in a previous study including a lower number of patients 19 …”

“…We could report these data because our study design distinguished patients with detectable plasma HIV viremia (even at low copy number) and those with a negative result, differently from previously published works, including HIV-HCV patients successfully treated with DAA, that define HIV suppression as having a plasma HIV-RNA lower than 50 copies/mL. 17,18 The percentage of subjects who achieved complete HIV viremia suppression was higher than that observed in a previous study including a lower number of patients. 19 The choice of SVR12 in the present study instead of a 24-week interval from anti-HCV treatment start may justify the different result and reinforce our hypothesis even though we cannot exclude that some patients could have a detectable but not quantifiable HIV-RNA if retested.…”

Renal safety of tenofovir alafenamide-based antiretroviral therapy in people with HIV: A mini-review

“…Furthermore, the R/F/TAF group showed improvement in renal function including UACR, RBP/Cr, and β2-MG/Cr, with median changes from baseline of -6.9%, -27.6%, and -70.0%, respectively. In the E/c/F/TAF group, the median changes were -1.2%, -18.2%, and -52.7% (63). In China, a multicenter study switched 243 HIVinfected patients with concurrent HCV infection and HIV virologic suppression to TAF-containing regimens and started a 12-week course of HCV treatment after 4 weeks.…”