Recommendations for the use of hepatitis C virus protease inhibitors for the treatment of chronic hepatitis C in HIV-infected persons. A position paper of the Italian Association for the Study of Infectious and Tropical Disease.

Abstract

The efficacy data obtained with boceprevir and telaprevir for persons with hepatitis C virus (HCV) genotype 1 infection raise the question of whether HCV protease inhibitors should be used in human immunodeficiency virus (HIV)/HCV co-infected persons. The Italian Association for the Study of Infectious and Tropical Diseases has made these recommendations to provide the rationale and practical indications for the use of triple anti-HCV therapy in persons living with HIV (PLWHIV). A Writing Committee of experts indicated by the President of the Association and a Consulting Committee con- tributed to the document. The final draft was submitted to the evaluation of external experts and the text modified according to their suggestions and comments. Treatment of HCV co-infection should be considered for all HCV RNA positive PLWHIV. Response-guided therapy with pegylated interferon and ribavirin is the standard treatment of PLWHIV with infection by HCV genotype 2, 3, 4, 5 and 6. Boceprevir and telaprevir should be used to treat HCV genotype 1 infection in HIV/HCV co-infected patients for 48 weeks on an individual basis, with close monitoring of their efficacy and tolerability with concur- rent antiretroviral therapy, taking into account potential drug-drug interactions. The decision to treat a patient or to wait for better treatment options, or to discontinue treatment should be made on an individual basis taking into account pre-treatment variables and the on-treatment HCV RNA kinetics.

• Authors: Orlando Armignacco, Massimo Andreoni, Evangelista Sagnelli, Massimo Puoti, Raffaele Bruno, Giovanni Battista Gaeta, Carlo F Perno, Teresa A Santantonio, Paolo Bonfanti, Stefano Bonora, Marco Borderi, Antonella Castagna, Antonella d'Arminio Monforte, Andrea De Luca, Paolo Grossi, Giovanni Guaraldi, Franco Maggiolo, Cristina Mussini, Caterina Sagnelli, Marcello Tavio, Carlo Torti, Caterina Uberti-Foppa, Massimo Andreoni, Gioacchino Angarano, Andrea Antinori, Orlando Armignacco, Giampiero Carosi, Antonio Chirianni, Giovanni Di Perri, Massimo Galli, Adriano Lazzarin, Giuliano Rizzardini, Evangelista Sagnelli, Gloria Taliani
• Journal: The new microbiologica (New Microbiol) Vol. 37 Issue 4 Pg. 423-38 (Oct 2014) ISSN: 1121-7138 [Print] Italy
• PMID: 25387281 (Publication Type: Journal Article, Practice Guideline)

Chemical References

• Antiviral Agents
• Protease Inhibitors

Topics

• Humans
• Antiviral Agents (therapeutic use)
• Coinfection (drug therapy, virology)
• Hepacivirus (drug effects, physiology)
• Hepatitis C, Chronic (drug therapy, virology)
• HIV Infections (drug therapy, virology)
• HIV-1 (drug effects, physiology)
• Italy
• Medication Reconciliation
• Protease Inhibitors (therapeutic use)
• Treatment Outcome