AIM: We aimed to investigate the safety and efficacy of interferon (IFN) and ribavirin (RBV)-free therapy with sofosbuvir along with daclatasvir (SOF/DCV) in HIV/hepatitis C virus (HCV)-coinfected patients (HIV/HCV), who have an urgent need for effective antiviral therapy. We also assessed its impact on liver stiffness and liver enzymes. DESIGN: Thirty-one patients thoroughly documented HIV/HCV with advanced liver disease (advanced liver fibrosis and/or portal hypertension) who were treated with SOF/DCV were retrospectively studied. METHODS: The following treatment durations were applied: HCV-genotype (HCV-GT)1/4 without cirrhosis: 12 weeks; HCV-GT1/4 with cirrhosis: 24 weeks; HCV-GT3: 24 weeks; if HCV-RNA was detectable 4 weeks before the end of treatment, treatment was extended by 4 weeks at a time. RESULTS: Fifty-two percent of patients were treatment-experienced. The majority of patients had HCV-GT1 (68%), whereas HCV-GT3 and HCV-GT4 were observed in 23 and 10% of patients, respectively. Ninety-four percent had liver stiffness greater than 9.5 kPa or METAVIR fibrosis stage higher than F2 and 45% had liver stiffness above 12.5 kPa or METAVIR F4. Portal hypertension (HVPG ≥6 mmHg) and clinically significant portal hypertension (HVPG ≥10 mmHg) were observed in 67% (18/27) and 26% (7/27) of patients, respectively. Sustained virologic response 12 weeks after the end of treatment (SVR12) was achieved in 100% (31/31). Treatment with SOF/DCV was generally well tolerated and there were no treatment discontinuations. HCV eradication improved liver stiffness from 11.8 [interquartile range (IQR): 11.5 kPa] to 6.9 (IQR: 8.2) kPa [median change: -3.6 (IQR:5.2) kPa; P < 0.001] and decreased liver enzymes. The mean time period between treatment initiation and follow-up liver stiffness measurement was 32.7 ± 1.2 weeks. CONCLUSION: IFN- and RBV-free treatment with SOF/DCV was well tolerated and achieved SVR12 in all HIV/HCV with advanced liver disease. It also significantly improved liver stiffness, suggesting anti-fibrotic and anti-portal hypertensive effects.
AIM: We aimed to investigate the safety and efficacy of interferon (IFN) and ribavirin (RBV)-free therapy with sofosbuvir along with daclatasvir (SOF/DCV) in HIV/hepatitis C virus (HCV)-coinfectedpatients (HIV/HCV), who have an urgent need for effective antiviral therapy. We also assessed its impact on liver stiffness and liver enzymes. DESIGN: Thirty-one patients thoroughly documented HIV/HCV with advanced liver disease (advanced liver fibrosis and/or portal hypertension) who were treated with SOF/DCV were retrospectively studied. METHODS: The following treatment durations were applied: HCV-genotype (HCV-GT)1/4 without cirrhosis: 12 weeks; HCV-GT1/4 with cirrhosis: 24 weeks; HCV-GT3: 24 weeks; if HCV-RNA was detectable 4 weeks before the end of treatment, treatment was extended by 4 weeks at a time. RESULTS: Fifty-two percent of patients were treatment-experienced. The majority of patients had HCV-GT1 (68%), whereas HCV-GT3 and HCV-GT4 were observed in 23 and 10% of patients, respectively. Ninety-four percent had liver stiffness greater than 9.5 kPa or METAVIR fibrosis stage higher than F2 and 45% had liver stiffness above 12.5 kPa or METAVIR F4. Portal hypertension (HVPG ≥6 mmHg) and clinically significant portal hypertension (HVPG ≥10 mmHg) were observed in 67% (18/27) and 26% (7/27) of patients, respectively. Sustained virologic response 12 weeks after the end of treatment (SVR12) was achieved in 100% (31/31). Treatment with SOF/DCV was generally well tolerated and there were no treatment discontinuations. HCV eradication improved liver stiffness from 11.8 [interquartile range (IQR): 11.5 kPa] to 6.9 (IQR: 8.2) kPa [median change: -3.6 (IQR:5.2) kPa; P < 0.001] and decreased liver enzymes. The mean time period between treatment initiation and follow-up liver stiffness measurement was 32.7 ± 1.2 weeks. CONCLUSION:IFN- and RBV-free treatment with SOF/DCV was well tolerated and achieved SVR12 in all HIV/HCV with advanced liver disease. It also significantly improved liver stiffness, suggesting anti-fibrotic and anti-portal hypertensive effects.
Authors: David Chromy; Mattias Mandorfer; Theresa Bucsics; Philipp Schwabl; Bernhard Scheiner; Caroline Schmidbauer; Maximilian Christopher Aichelburg; Peter Ferenci; Michael Trauner; Markus Peck-Radosavljevic; Thomas Reiberger Journal: United European Gastroenterol J Date: 2019-03-06 Impact factor: 4.623
Authors: Lisa Steininger; David Chromy; David Bauer; Benedikt Simbrunner; Teresa Binter; Philipp Schwabl; Caroline Schmidbauer; Michael Trauner; Michael Gschwantler; Mattias Mandorfer; Thomas Reiberger Journal: Wien Klin Wochenschr Date: 2020-12-22 Impact factor: 1.704
Authors: Bernhard Scheiner; Philipp Schwabl; Sebastian Steiner; Theresa Bucsics; David Chromy; Maximilian C Aichelburg; Katharina Grabmeier-Pfistershammer; Michael Trauner; Markus Peck-Radosavljevic; Thomas Reiberger; Mattias Mandorfer Journal: Medicine (Baltimore) Date: 2016-07 Impact factor: 1.889
Authors: Sebastian Steiner; Theresa Bucsics; Philipp Schwabl; Mattias Mandorfer; Bernhard Scheiner; Maximilian Christopher Aichelburg; Katharina Grabmeier-Pfistershammer; Peter Ferenci; Michael Trauner; Markus Peck-Radosavljevic; Thomas Reiberger Journal: Wien Klin Wochenschr Date: 2017-01-27 Impact factor: 1.704
Authors: David Chromy; Philipp Schwabl; Theresa Bucsics; Bernhard Scheiner; Robert Strassl; Florian Mayer; Maximilian C Aichelburg; Katharina Grabmeier-Pfistershammer; Michael Trauner; Markus Peck-Radosavljevic; Thomas Reiberger; Mattias Mandorfer Journal: Wien Klin Wochenschr Date: 2017-07-25 Impact factor: 1.704