CROI 2014In a study of people coinfected with hepatitis C virus (HCV) and HIV, Gilead Sciences’ recently approved Sovaldi (sofosbuvir) and ribavirin cured 75 percent of those with genotype 1, aidsmap reports. While cure rates for genotype 2 were higher, they were diminished for genotype 3, which under current treatment guidelines has replaced genotype 1 as the most difficult to treat genotype. Results from the open-label Phase III PHOTON-1 trial of the NS5B polymerase inhibitor Sovaldi plus ribavirin were presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

A total of 114 treatment-naive coinfected people with genotype 1, 4 percent of whom had cirrhosis, received Sovaldi and ribavirin for 24 weeks. Another 68 treatment-naive participants and 41 treatment-experienced participants with genotypes 2 or 3 also received the regimen, but for varying lengths of time: Those who had not been treated before received only 12 weeks of treatment while prior non-responders were treated for 24 weeks. Twenty-four percent of the genotype 2 and 3 group had cirrhosis.

Over 90 percent of the study population was taking antiretrovirals for HIV. The average CD4 count was higher than 600.

Seventy-five percent of the genotype 1 group achieved a sustained virologic response 24 weeks after completing therapy (SVR24, considered a cure). Eighty-eight percent of the treatment-naive genotype 2 participants were cured. Treatment-naive genotype 3s did not fare as well, however: Only 67 percent achieved an SVR24. Treatment-experienced genotype 2s and 3s had respective cure rates of 92 percent and 94 percent.

The regimen was generally safe and well tolerated. Thirteen people experienced serious side effects, with seven of them stopping therapy as a result. The most common side effects were fatigue, insomnia, headache and nausea.

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To watch a webcast of the CROI presentation, click here.