1. HIV/HCV Coinfection News – HCV Protease Inhibitors
Juergen Rockstroh, MD
Marc Poliquin, MD

2. Efficacy of HCV Protease Inhibitors in Co-Infected Patients
Telaprevir + PegIFN/r
Undetectable HCV RNA at week 12
86% TP/r vs 33% placebo
Undetectable HCV RNA at week 24
74% TP/4 vs 55% placebo
Boceprevir+ PegIFN/r
Undetectable HCV RNA at week 12
59.4% BOC+ P/r vs. 23.5% P/r
Undetectable HCV RNA at week 24
73.4% BOC+ P/r vs. 32.4% P/r
Dieterich D et al. Telaprevir in Combination with Pegylated Interferon--2a+RBV in HCV/
HIV-co-infected Patients: A 24-Week Treatment Interim Analysis. CROI 2012 Paper #46
Sulkowski M et al. Boceprevir + Pegylated Interferon + Ribavirin for the Treatment of
HCV/HIV-co-infected Patients: End of Treatment (Week-48) Interim Results. CROI 2012 Paper #47

3. Drug-Drug Interactions with Boceprevir (BOC)
Tenofovir
Efavirenz
Ritonavir
Drug Effect on BOC
None
slight reduction in AUC(0-8h) and Cmax (19% and 8%, respectively)
44% decrease in Cmin
decreased AUCt by 19%
BOC Effect on Drug
No notable effect on AUC or renal clearance, but increased Cmax by 32%.
slightly increased AUC(0-24h) & Cmax (20% & 11%, respectively)
Kasserra C. et al. Clinical Pharmacology of BOC: Metabolism, Excretion, and
Drug-Drug Interactions . CROI 2011 Paper #118

4. IL-28B Genotype and Treatment Response to PegIFN-RBV
Rivero-Juarez A. et al. IL28B and the LDLr Have a Synergistic Effect on HCV Early Viral Kinetics during
the First Weeks of Treatment with Pegylated Interferon + Ribavirin in HIV/HCV-co-infected Patients.
CROI 2012 Paper #765

5. Predictors of Non-Response to Therapy with PegIFN-RBV
Prometheus AUROC
Sensitivity
Prometheus Index
Specificity
Available at:
iTunes App Store
Android Market
Medrano J. et al. Baseline Prediction of Response to Pegylated Interferon + Ribavirin in Chronic
HCV Using the Prometheus Score. CROI 2012 Paper #761

6. IL28B Genotype and HCV Viral Load
Predictive values for SVR in patients infected with HCV genotype 1 (n=79).
PPV
NPV
Sensitivity
Specificity
rs TT (n=53)
45.2%
80.7%
82.7%
42.0%
Total nuclear-STAT1 (<5%) (n=30)
50.0%
71.4%
51.7%
70.0%
rs TT or total nuclear-STAT1 (<5%) (n=61)
42.6%
83.3%
89.6%
30.0%
rs TT and total nuclear-STAT1 (<5%) (n=22)
59.0%
71.9%
44.8%
82.0%
Nuclear-STAT1, STAT1-nuclear translocation; PPV, positive predictive value; NPV, negative predictive value.
Miyamura T, et al. Hepatic STAT1-nuclear translocation and interleukin 28B polymorphisms
predict treatment outcomes in hepatitis C virus genotype 1-infected patients.
PLoS One. 2011;6(12):e Epub 2011 Dec 12.

7. Electronic Tools for Assessing Drug-Drug Interactions in HIV Infected Patients
Online drug interaction charts
HIV iChart
iPhone & Android app
available on iTunes and the
Android Market
iPhone Screenshot from iTunes Store

8. Incidence of HCV in the Swiss HIV Cohort Study, by Transmission Group
Wandeler G.. et al. HCV Incidence in the SHCS: A Changing Epidemic . CROI 2012 Paper #743

9. 2011 Treatment Guidelines AIDS 2011 Feb 20;25(4):399-409.
Acute hepatitis C in HIV-infected individuals: recommendations from the European AIDS Treatment Network (NEAT) consensus conference.
European AIDS Treatment Network (NEAT) Acute Hepatitis C Infection Consensus Panel.

10. The Role of Ribavirin in Treating HCV in Co-infected MSM
In group 2,
Sustained virological response (SVR) rates were significantly higher for peg-IFN+RBV (31 of 33) peg-IFN mono-therapy (6 of 10) (94% vs 60%, respectively; p = 0.02).
SVR was significantly associated with Peg-IFN+RBV combination therapy (p = 0.037) and rapid virological response (p ≤0.0001)
In group 1
SVR was only significantly associated with rapid virological response (p ≤0.0001)
HCV Genotype
GT1
GT2
GT3
GT4
Percent infected
68%
4.6%
10.6%
16.9%
Boesecke C. et al. Ribavirin Is Needed in Addition to Pegylated Interferon for Optimal
Treatment Responses in the Treatment of Acute HCV Genotype 2 and 3 Infection I
HIV-co-infected Individuals . CROI 2012 Paper #50

11. Repeated Co-Infection With HCV in HIV Positive MSM
Outcome of acute HCV according to episode number, pending patients on treatment
Ingiliz P. et al. Prior HCV Infection Does Not Protect from Sexually Transmitted HCV
Reinfection in HIV+ MSM. CROI 2012 Paper #752