Potential for Drug-Drug Interactions between Antiretrovirals and HCV Direct Acting Antivirals in a Large Cohort of HIV/HCV Coinfected Patients

Development of direct acting antivirals (DAA) offers new benefits for patients with chronic hepatitis C. The combination of these drugs with antiretroviral treatment (cART) is a real challenge in HIV/HCV coinfected patients. The aim of this study was to describe potential drug-drug interactions between DAAs and antiretroviral drugs in a cohort of HIV/HCV coinfected patients.

Cross-sectional study of all HIV/HCV coinfected patients attending at least one visit in 2012 in the multicenter French Dat’AIDS cohort. A simulation of drug-drug interactions between antiretroviral treatment and DAAs available in 2015 was performed.

Of 16,634 HIV-infected patients, 2,511 had detectable anti-HCV antibodies, of whom 1,196 had a detectable HCV-RNA and were not receiving HCV treatment at the time of analysis. 97.1% of these patients were receiving cART and 81.2% had a plasma HIV RNA <50 copies/mL. cART included combinations of nucleoside reverse transcriptase inhibitors with a boosted protease inhibitor in 43.6%, a non-nucleoside reverse transcriptase inhibitor in 17.3%, an integrase inhibitor in 15.4% and various combinations or antiretroviral drugs in 23.7% of patients. A previous treatment against HCV had been administered in 64.4% of patients. Contraindicated associations/potential interactions were expected between cART and respectively sofosbuvir (0.2%/0%), sofosbuvir/ledipasvir (0.2%/67.6%), daclatasvir (0%/49.4%), ombitasvir/boosted paritaprevir (with or without dasabuvir) (34.4%/52.2%) and simeprevir (78.8%/0%).

Significant potential drug-drug interactions are expected between cART and the currently available DAAs in the majority of HIV/HCV coinfected patients. Sofosbuvir/ledipasvir and sofosbuvir/daclatasvir with or without ribavirin appeared the most suitable combinations in our population. A close collaboration between hepatologists and HIV/AIDS specialists appears necessary for the management of HCV treatment concomitantly to cART.

Below:  Distribution of antiretroviral drugs received in 1161 HIV/HCV coinfected patients under cART and potential drug-drug interactions between antiretrovirals and currently available DAAs (patients not under antiretroviral treatment, patients under HCV treatment at the time of analysis and patients with HCV reinfection excluded).

Full article at: http://goo.gl/x9VjKZ

By: Isabelle Poizot-Martin, Véronique Obry-Roguet

Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic, Marseille, France

Isabelle Poizot-Martin

Inserm U912 (SESSTIM), Marseille, France

Alissa Naqvi, Pascal Pugliese

CHU de Nice, Hôpital Archet 1, Service de Maladies Infectieuses, Unité de Virologie Clinique, Nice, France

Marc-Antoine Valantin

Sorbonne Universités, UPMC Université Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France

Marc-Antoine Valantin

APHP, Groupe hospitalier Pitié-Salpêtrière-Université Pierre et Marie Curie, Service de Maladies Infectieuses et Tropicales, Paris, France

Lise Cuzin

INSERM, UMR 1027, Toulouse, F-31000, France; Université de Toulouse III, Toulouse, F-31000, France; CHU Toulouse, COREVIH Toulouse, F-31000, France

Eric Billaud

Service des maladies infectieuses, CHU, Hôtel-Dieu, Nantes, France

Antoine Cheret

Centre Hospitalier de Tourcoing, Service Universitaire de Maladies Infectieuses, Tourcoing, France

Antoine Cheret

CHU Bicêtre, Service de Médecine Interne, Le Kremlin-Bicêtre, France

Antoine Cheret, Claudine Duvivier

Laboratoire de Virologie, Hôpital Necker EA 7327 Université Paris Descartes, Paris, France

David Rey

Hôpitaux Universitaires de Strasbourg, Center for HIV care, Strasbourg, France

Christine Jacomet

CHU Clermont-Ferrand, Service des Maladies Infectieuses et tropicales, Clermont-Ferrand, France

Claudine Duvivier

APHP-Hopital Necker, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur IHU Imagine, Paris, France

Claudine Duvivier

Institut Pasteur, Centre Médical—Centre d'Infectiologie Necker-Pasteur, Paris, France

Pierre Pradat

Hospices civils de Lyon, Hôpital de la Croix Rousse, Service d’Hépatologie, Centre de recherche clinique, Lyon, France

Pierre Pradat, Laurent Cotte

Inserm U1052, Lyon, France

Laurent Cotte

Hospices civils de Lyon, Hôpital de la Croix Rousse, Service des maladies infectieuses, Lyon, France

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