CROI 2012: Hep C Drug Incivek Improves HCV Cure Rate in People With HIV

Results from a small study of 62 co-infected people treated with Incivek showed that 74% had undetectable viral loads at 12 weeks after stopping their hepatitis C treatment, compared to 45% on pegylated interferon + ribavirin alone. About one-quarter were not on HIV treatment (13) while most (47) were taking Atripla or boosted Reyataz (atazanavir) + Truvada (Viread/tenofovir + Emtriva/emtricitabine).

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):

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.