Most HIV patients need treatment for acute HCV

May 5, 2018|Infectious Disease Practitioner

REPORTING FROM CROI

Eight weeks is enough

The efficacy of an 8-week treatment course was established in a study of 63 MSM in the Netherlands and Belgium. They were 47 years old, on average, and all but three were HIV positive; two-thirds had HCV genotype 1, and the rest had genotype 4, some with extremely high viral loads.

Subjects received grazoprevir/elbasvir (Zepatier) once daily for 8 weeks, beginning at a mean of 4.5 months after their estimated infection date, and all within 6 months. Twelve weeks after the end of therapy, 59 (94%) were negative for HCV RNA on blood tests. Three of the patients who were still positive for HCV had new infections; the remaining patient had relapsed, and was the only true treatment failure.

“We can say that 8 weeks of grazoprevir/elbasvir for acute HCV was safe, highly effective, and noninferior compared to studies with longer treatment. On an individual level, you can wait for spontaneous clearance, but on the population level, by treating all patients in the acute phase, you prevent spread of hepatitis C,” said lead investigator Anne Boerekamps, PhD, of Erasmus University Medical Center, Rotterdam, Netherlands.