P-D12 Rapid and Selective Increase in LDL levels in HCV genotype-1 infected patients using IFN/RBV-free regimens independent of HIV co-infection and treatment duration

Abstract

Background: Hepatitis C (HCV) and HIV infection are both associated with altered metabolism and dyslipidemia. However, treatment for Hepatitis C (HCV) is rapidly evolving to interferon-free, directly acting antiviral agent (DAA) regimens and the effect of these new regimens on lipid concentration is currently unknown. Methods: We examined fasting lipid changes over the course of treatment in 2 single-center studies evaluating DAA-only therapy conducted at NIAID in HCV-monoinfected and HIV/HCV co-infected patients. In 2 arms of the NIAID SYNERGY study, forty HCV monoinfected patients were treated using sofosbuvir (400 mg) and ledipasvir (90 mg) (SOF/LDV) once daily combined with GS-9669 or GS-9451for 6 weeks (N = 20 each). In the NIAID ERADICATE study fifty HIV/HCV coinfected subjects were treated with SOF/LDV for 12 weeks. Fasting lipids and NMR LipoProfile were estimated frequently after initiation of treatment. Changes in levels of lipids from baseline were analyzed using 1-way ANOVA and compared between 2 groups using Dunnett's multiple comparisons test. Results: In both HCV monoinfected and HIV/HCV coinfected patients, low-density lipoprotein (LDL) cholesterol concentration, but not VLDL or triglycerides increased quickly on therapy (p0.05). Conclusions: The rapid increase of LDL concentration is associated with a rapid virologic response in IFN/RBV-free HCV treatment independent of HIV status or duration of treatment.