March 28, 2012
I have said for a long time that once we got some specially targeted hepatitis C (HCV) drugs, HIV/HCV-coinfected patients would finally have a great chance at an HCV cure. Well, the news from CROI 2012 seems to suggest just that.
If you remember from my prior blog entry, I summarized data on Victrelis (boceprevir). Researchers showed data on HIV/HCV-coinfected patients who still have HCV suppression at 12 weeks after stopping treatment. In this entry, I will discuss similar data on Incivek (telaprevir), the other recently approved HCV protease inhibitor.
For the Incivek study presented at CROI 2012, 60 HIV/HCV-coinfected patients were given either triple therapy (Incivek plus PEG interferon plus ribavirin) or dual therapy (placebo plus PEG interferon plus ribavirin). The 12-week post-treatment data show that 74 percent of patients who got triple therapy had no detectable HCV compared to 45 percent of patients who got dual therapy. Also impressive is the small number of patients on triple therapy whose virus rebounded after treatment discontinuation.
The other good news is that the drug levels for Incivek seemed to be good no matter what HIV cocktail the patient was taking. (This does not mean the drug is safe to take with HIV protease inhibitors, however; remember my previous blog entry on drug interactions, in which I noted that there are only three HIV treatment regimens that are recommended with Incivek.)
No new side effects were seen with the addition of Victrelis than what we already know to be issues: Rash, itching, headache and nausea are common. Anemia was also seen in the blood work; not a new issue, just needs careful follow-up.
If the trend on viral suppression continues to 24 weeks after stopping treatment, it will suggest that these great treatment responses are durable. We will know more about this key time point later this year.