Victrelis/PEG-IFN/RBV for 12 weeks efficacious for acute HCV in HIV-positive men

Victrelis in combination with pegylated interferon alpha and ribavirin for 12 weeks was effective for the treatment of acute hepatitis C virus infection in HIV-positive men who have sex with men, according to recently published findings in the Journal of Hepatology.

Researchers sought to determine if the addition of a protease inhibitor to a treatment regimen of pegylated interferon alpha (PEG-IFN) and ribavirin (RBV) could shorten treatment duration for HIV-positive MSM with acute HCV, without losing efficacy. Therefore they conducted an open-label, single arm study of 127 men enrolled in 10 Dutch HIV treatment centers. Only 65 men in the cohort had acute HCV genotype 1 infection and were assigned treatment with Victrelis (boceprevir, Merck) plus PEG-IFN and RBV for 12 weeks.

“The primary endpoint of the study was achievement of sustained virological response rate at week 12 in patients reaching a rapid viral response at week 4, and SVR12 in the intent-to-treat entire study population was the most relevant secondary endpoint,” the researchers wrote.

Fifty-seven men initiated treatment within 26 weeks after diagnosis of the infection. Among all the patients, 72% experienced rapid viral response at 4 weeks. Of the patients who reached rapid response, 100% of them reached SVR12.

In the intention-to-treat group, SVR12 was 86% and comparable to SVR12 rate from 73 controls treated for 24 weeks with PEG-IFN and RBV in the same study centers (84%).

“With the addition of boceprevir to [PEG-IFN] and RBV, treatment duration of [acute] HCV genotype 1 can be reduced to 12 weeks without loss of efficacy,” the researchers concluded. “Given the high drug costs and limited availability of interferon-free regimens, boceprevir, [PEG-IFN] and RBV can be considered a valid treatment option for [acute] HCV.”