People coinfected with both HIV and hepatitis C virus (HCV) genotype 1 who added 12 weeks of telaprevir (Incivek) to pegylated interferon and ribavirin (P/R) had better 24-week on-treatment response rates than those who used pegylated interferon and ribavirin alone. These data were presented at the 62nd Annual Meeting for the American Association for the Study of Liver Diseases (AASLD), November 4-8, 2011 in San Francisco.
Telaprevir was approved earlier this year for use in combination with P/R to treat people infected with HCV genotype 1, but who were not infected with HIV. Adding 12 weeks of telaprevir to P/R therapy resulted in substantial increases in the number of people who achieved sustained virological response (SVR), which is maintaining undetectable HCV levels 24 weeks after completing treatment and which is essentially considered a cure. This has given hope to people who are coinfected with HCV and HIV that adding telaprevir to P/R might substantially boost SVR rates for them as well.
The first studies are beginning to test telaprevir in coinfected individuals and researchers presented data at AASLD on response rates through the first six months of treatment. Â Future presentations will report on SVR rates.
In the reported study, people were broken up into one of four different groups. The first two groups compared telaprevir plus P/R in to P/R alone in people who hadn’t yet started HIV antretroviral (ARV) drugs. The other two groups compared telaprevir plus P/R to P/R alone in people taking either an efavirenz (Sustiva)-based ARV regimen or an atazanavir (Reyataz)-based regimen. Because various ARV therapies can lower telaprevir blood levels researchers felt it was best to limit the ARV regimens a person could take during the study to just two that were well understood.
Through the first 12 weeks of therapy, people taking telaprevir plus P/R were far more likely to achieve undetectable HCV levels than people taking P/R alone, regardless of whether they were taking HIV ARV treatment. This generally held true through 24 weeks, though the difference in HCV suppression between those taking telaprevir plus P/R to those taking P/R alone diminished somewhat, especially in those who also took ARVs.
Side effects were similar to what was seen in trials infected with HCV alone, with the exception that there were more elevations of a liver enzyme called billirubin in those who also took atazanavir, which on its own is known for billirubin increases.
The trial is ongoing, and further data from the study are expected in 2012.