Interferon-Free Anti-HCV Therapy Has a Better Treatment Response Rate and Adherence Than Interferon-Based Therapy for Patients With HCV/HIV Coinfection: A Single-Center Retrospective Study

Abstract

In the last decade, the standard treatment for hepatitis C virus (HCV)-infected patients has been pegylated interferon (IFN) and daily ribavirin from 24 to 48 weeks. Many patients are unable to tolerate the treatment, or have other contraindications, especially in difficult-to-treat populations such as HCV/human immunodeficiency virus (HIV) co-infected patients. The introduction of IFN-free anti-HCV therapy has resulted in a better therapeutic response with fewer side effects and is significantly beneficial to such patients. In the present study, we aimed to compare the clinical impact of IFN-free therapy in this difficult-to-treat patient population in real-world practice. We conducted a retrospective study from November 2007 to June 2019 involving 50 HCV- and HIV-infected patients who received anti-HCV therapy in our institution. Clinical features and treatment responses were analyzed. The mean patient age was 43.3 years, and 86% were male. Twenty percent of the patients had cirrhosis. The most prevalent HCV genotype was type 1 (54%), followed by type 6 (20%), type 3 (14%), and others (12%). The overall sustained virologic response (SVR) rate was 84% in this cohort. The patients in the direct-acting antiviral agent (DAA) treatment group were older on average, and a higher proportion had cirrhosis. The patients undergoing DAA-based treatment had a higher SVR rate than those receiving IFN-based therapy (96% vs. 68%, p = 0.016). Two patients in each group demonstrated virological non-response to treatment. A high discontinuation rate was noted in the IFN-based group (27% vs. 0%, p = 0.0035) as compared with the DAA group. IFN-free therapy is associated with a significantly higher treatment response rate and better adherence than IFN-based therapy.