Spotlight Series on Hepatitis C

2014 HIV/Hepatitis C Coinfection Update

February 7, 2014


The Second Wave Arrives

The Second Wave Arrives

Two more HCV drugs were newly approved in late 2013: the protease inhibitor simeprevir (Olysio) and the nucleotide polymerase inhibitor sofosbuvir (Sovaldi).

By comparison to the two previously approved HCV protease inhibitors, simeprevir appears to be significantly more friendly toward coadministration with HIV medications (particularly HIV protease inhibitors) and has a high efficacy rate in HCV treatment-naive coinfected patients, even allowing many to dramatically shorten the typical course of HCV therapy. However, the drug must still be coadministered with peginterferon, leaving toxicity as a major issue.

Peginterferon is also part of a sofosbuvir-containing regimen at the moment, but only for genotype 1 patients. For patients with genotype 2 or 3, the drug is dosed alongside only ribavirin, and dramatically lower adverse event rates accompany that indication. Sofosbuvir also appears to have virtually no interactions with HIV antiretrovirals.

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