Monday, March 26, 2012

CROI 2012: Hep C drug Incivek improves HCV cure rate in people with HIV

Incivek + pegylated interferon + ribavirin was given for the first 12 weeks, and then interferon + ribavirin only for the next 36 weeks. The average age of the participants was 45, and only 15% were women. Most people had HCV viral loads above 800,000, while 10% had advanced liver fibrosis. Nearly 68% had HCV genotype 1a while the others had 1b, both of which are more difficult to treat types.

The following chart describes 12-week post-treatment undetectable HCV viral loads (T/PR = Incivek + pegylated interferon + ribavirin):

 No HIV medsAtriplaReyatazTotal
4 wks71%0%75%12%60%0%68%5%
12 wks86%33%88%25%73%38%82%32%
24 wks86%0%75%50%67%75%74%55%
12 wks post71%33%69%50%80%50%74%45%

 The following details should be noted about this study:
  • 25 people had stopped HCV treatment by week 48.
  • Those who took Sustiva had their Incivek dose increased to 1,125mg from 750mg due to known interaction between the two drugs.
  • Despite undetectable HCV viral loads at week 48, three people had their HCV levels return.
  • CD4 counts tended to decrease in everyone, a common response to HCV treatment in co-infection. However, the CD4% did not change.
  • No one experienced detectable HIV viral load.
  • High rates of side effects were seen in the Incivek group, including: headache (37%), nausea (34%), rash (34%), itching (39%), fever (21%), anemia (18%), and depression (21%).
Larger studies will be conducted. These will include people new to HCV treatment, people who rebounded after HCV treatment, partial responders, and non-responders.

For other coverage on this topic:

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