Liver

15 - Sofosbuvir, Velpatasvir, Veloxpravir Efficacy in 12-Week Treatment in Triple Infected (Chronic Hepatitis C, Chronic Hepatitis B, and HIV) Geno 3 Naive Population: An Open Level Prospective Clinical Trial - SOLVVE - C

Monday, October 8
2:15 PM - 2:25 PM
Location: Terrace Ballroom 2-3 (level 400)

Category: Liver
Patrick Basu, MD, MRCP, FACG1, Nimy John, MD2, Mark Aloysius, MD, PhD3, Robert S. Brown, Jr., MD, MPH4
1Weill Cornell Medicine, Flushing, NY; 2St. Vincent Hospital/University of Massachusetts Medial School, Worcester, MA; 3James J. Peters VA Medical Center, Bronx, NY; 4Weill Cornell Medical College, New York, NY

Introduction: Chronic Hepatitis C treatment is no longer challenging in the era of DAAs with an SVR of up to 97%. Triple infection treatment with HCV, HIV and Hepatitis B has not been explored in real life situations. HCV Genotype 3 is still the most challenging clinical state in Hepatitis C treatment. Regardless of concomitant triple infection, shorter duration of therapy revealed favorable outcome with the highest retention, fewer side events, and cost containment. This study evaluates the efficacy and safety of Sofosbuvir, Velpatasvir, and Veloxpravir in the treatment of triple infection with HBV, HIV, and HCV (Genotype 3).

Methods: Twenty-two (n = 22) HCV treatment-naive patients with Triple Infection (HIV HBV HCV Genotype 3) were recruited for the study.

Patients with HIV were on Atripla for over three years with HIV with Undetectable Viral load and HBV Viral load Undetectable. HCV infected patients had a Median Viral load of 3 million IU and Genotype 3 prior to treatment.

Demographics: Table 1

Out of 22 patients with genotype3, 10 patients had genotype 3a, 9 patients had genotype 3c and 3 patients genotype 3b. Out of the total 22 patients,19 patients were HBeAg negative and 3 were HBeAg positive. Mean year of HIV and HCV acquisition was 20 years.

Exclusion Criteria: Active Drug Abuse or excess Alcohol intake, CHF NY heart Type IV, Cardiomyopathy, Arrhythmia, COPD, Renal Failure with creatinine clearance less than 30 %, Decompensated Cirrhotic HCC, Transplant Recipients.

Results: Table 2

One patient dropped out of the study due to severe bilateral Pneumonia.

One patient stopped therapy due to Rectal Bleed after three weeks of treatment.

One patient stopped therapy due to Virologic Failure with RAS y93.

One patient developed Herpes Zoster in the 10th week of treatment.

Intention to Treat (ITT): 18/21

Resistance-associated substitution(RAS): Pre-therapy & Post-therapy

RAS increased posttreatment in RAS 31 and RAS 36. No change was seen in regards to treatment in RAS 93.

Side events: Bilateral pneumonia, Headache, Fatigue, Vomiting, Rectal vomiting, Abdominal pain, Bloating, Insomnia, Skin rash, AST elevation, Anemia, Hemolysis, Constipation, Diarrhoea, Sinusitis, URI, Chest pain, Herpes Zoster.

Discussion: The study demonstrates the efficacy of DAAs in 12-week treatment with an SVR of 87% in a very challenging triple infected cohort, with significant efficacy, tolerability, and safety. A larger trial is needed to validate the results.

Table 1
Table 2

Disclosures:
Patrick Basu indicated no relevant financial relationships.
Nimy John indicated no relevant financial relationships.
Mark Aloysius indicated no relevant financial relationships.
Robert Brown: Abbvie – Consultant, Grant/Research Support. BMS – Consultant, Grant/Research Support. Gilead – Consultant, Grant/Research Support. Merck – Consultant, Grant/Research Support.

Nimy John

PGY-3 Resident
St. Vincent Hospital/University of Massachusetts Medial School
Worcester, Massachusetts

Presentation(s):

Send Email for Nimy John


Assets

15 - Sofosbuvir, Velpatasvir, Veloxpravir Efficacy in 12-Week Treatment in Triple Infected (Chronic Hepatitis C, Chronic Hepatitis B, and HIV) Geno 3 Naive Population: An Open Level Prospective Clinical Trial - SOLVVE - C



Attendees who have favorited this

Please enter your access key

The asset you are trying to access is locked. Please enter your access key to unlock.

Send Email for Sofosbuvir, Velpatasvir, Veloxpravir Efficacy in 12-Week Treatment in Triple Infected (Chronic Hepatitis C, Chronic Hepatitis B, and HIV) Geno 3 Naive Population: An Open Level Prospective Clinical Trial - SOLVVE - C