A multicenter team of researchers report that in a phase III clinical trial, a combination drug therapy cures chronic hepatitis C in the majority of patients co-infected with both HIV and hepatitis C.
"In many settings, hepatitis C is now a leading cause of death among HIV co-infected patients," said Mark Sulkowski, from the Johns Hopkins University School of Medicine.
Approximately one-third of HIV patients in the US have hepatitis C, with an estimated 7 million co-infected patients worldwide.
Because of poor tolerability to the previous standard of treatments for hepatitis C, including injections of interferon-alpha and medications that can have interactions with anti-retroviral medications used to treat HIV, this population of co-infection patients has been considered difficult to treat.
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In total, doctors administered sofosbuvir and ribavirin to a total of 223 HIV-1 patients chronically co-infected with hepatitis C (genotypes 1, 2 or 3) either for 12 weeks (for treatment-naive patients with genotype 2 or 3) or for 24 weeks (for treatment-naive patents with genotype 1 or treatment-experienced patents with genotype 2 or 3).
Twelve weeks after treatment ended, researchers tested patients again for hepatitis C infection to determine if treatment was effective.
For treatment-naive patients, 76 per cent with genotype 1, 88 per cent with genotype 2 and 67 per cent with genotype 3 were cured.
Treatment-experienced patients had even better cure rates: 92 per cent for patients with genotype 2 and 94 per cent for patients with genotype 3.
Seven patients discontinued treatment because of adverse events, but there were no observed adverse effects on HIV or its treatment.
"The likelihood that a patient with chronic, long-standing hepatitis C infection would have spontaneous cure is near zero, so if these patients had not been treated, none would have been cured," said Sulkowski.
The finding was published in The Journal of the American Medical Association.