The remarkable advances in
interferon-sparing, all-oral hepatitis C virus (HCV) treatment were a highlight of the 2014 Conference on Retroviruses and
Opportunistic Infections (CROI). The backbone of the
nucleotide inhibitor
sofosbuvir and the nonstructural
protein 5A (NS5A) inhibitor
ledipasvir with an additional third agent (HCV
protease inhibitor or HCV nonnucleoside
reverse transcriptase inhibitor) led to a sustained virologic response (SVR) rate 12 weeks after
cessation of treatment of 95% to 100% after only 6 weeks of treatment. These results demonstrate the potential of combination directacting
antiviral (DAA)
therapy for abbreviated, well-tolerated, and highly effective HCV treatment. Two triple-
drug regimens that comprised 12 weeks of an NS5A inhibitor, an HCV
protease inhibitor, and a nonnucleoside inhibitor also resulted in SVRs of more than 90% in patients with HCV genotype 1.
HIV coinfection does not appear to negatively impact response to DAA-based HCV
therapy, as evidenced by similar response rates in HIV/HCV-coinfected patients compared with HCV-monoinfected patients receiving interferonsparing or -containing regimens. There was continued emphasis at CROI 2014 on non-
AIDS complications of
HIV infection, specifically
cardiovascular disease,
renal insufficiency, and bone and endocrine disorders that persist among patients with treated HIV disease and contribute to morbidity and mortality. Finally, new data on novel drugs and combinations for treatment of
tuberculosis (TB), patient outcomes using new rapid TB diagnostics, and a short-course TB prevention strategy were presented.