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Efficacy and Safety of Glecaprevir/Pibrentasvir in Patients Coinfected With Hepatitis C Virus and Human Immunodeficiency Virus Type 1: The EXPEDITION-2 Study

BACKGROUND: Once-daily glecaprevir coformulated with pibrentasvir (glecaprevir/pibrentasvir) demonstrated high rates of sustained virologic response 12 weeks after treatment (SVR12) in patients with hepatitis C virus (HCV) genotype 1–6 infection. This phase 3 study evaluated the efficacy and safety...

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Detalles Bibliográficos
Autores principales: Rockstroh, Jürgen K, Lacombe, Karine, Viani, Rolando M, Orkin, Chloe, Wyles, David, Luetkemeyer, Anne F, Soto-Malave, Ruth, Flisiak, Robert, Bhagani, Sanjay, Sherman, Kenneth E, Shimonova, Tatiana, Ruane, Peter, Sasadeusz, Joseph, Slim, Jihad, Zhang, Zhenzhen, Samanta, Suvajit, Ng, Teresa I, Gulati, Abhishek, Kosloski, Matthew P, Shulman, Nancy S, Trinh, Roger, Sulkowski, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137115/
https://www.ncbi.nlm.nih.gov/pubmed/29566246
http://dx.doi.org/10.1093/cid/ciy220
Descripción
Sumario:BACKGROUND: Once-daily glecaprevir coformulated with pibrentasvir (glecaprevir/pibrentasvir) demonstrated high rates of sustained virologic response 12 weeks after treatment (SVR12) in patients with hepatitis C virus (HCV) genotype 1–6 infection. This phase 3 study evaluated the efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV genotype 1–6 and human immunodeficiency virus type 1 (HIV-1) coinfection, including patients with compensated cirrhosis. METHODS: EXPEDITION-2 was a phase 3, multicenter, open-label study evaluating glecaprevir/pibrentasvir (300 mg/120 mg) in HCV genotype 1–6/HIV-1–coinfected adults without and with compensated cirrhosis for 8 and 12 weeks, respectively. Patients were either HCV treatment-naive or experienced with sofosbuvir, ribavirin, or interferon, and antiretroviral therapy (ART) naive or on a stable ART regimen. Treatment-experienced genotype 3–infected patients were excluded. The primary endpoint was the SVR12 rate. RESULTS: In total, 153 patients were enrolled, including 16 (10%) with cirrhosis. The SVR12 rate was 98% (n = 150/153; 95% confidence interval, 95.8–100), with no virologic failures in 137 patients treated for 8 weeks. One genotype 3–infected patient with cirrhosis had on-treatment virologic failure. Most adverse events were mild in severity; 4 patients (2.6%) had serious adverse events, all deemed unrelated to glecaprevir/pibrentasvir. Treatment discontinuation was rare (<1%). All patients treated with ART maintained HIV-1 suppression (<200 copies/mL) during treatment. CONCLUSIONS: Glecaprevir/pibrentasvir for 8 weeks in noncirrhotic and 12 weeks in cirrhotic patients is a highly efficacious and well-tolerated treatment for HCV/HIV-1 coinfection, regardless of baseline HCV load or prior treatment with interferon or sofosbuvir. CLINICAL TRIAL REGISTRATION: NCT02738138.