Direct-Acting Antivirals (DAAs) for the treatment of HCV infection in HIV/HCV-coinfected patients: a real life experience

Despite the high rates of HIV control achieved by current antiretroviral therapy, HIV/HCV co-infection still has an unfavorable influence on the natural history of HCV, resulting in an increased rate of progression to cirrhosis, HCC and end stage liver disease. Although direct acting antivirals have proven effective in eradicating HCV infection in co-infected individuals, limited data on their effectiveness in real life settings are available to date.
Fifty-nine patients followed between March 2015 to March 2017 underwent three to six month DAAs-therapy, according to local and international guidelines. A database including demographic, clinical, laboratory and instrumental data, as well as outcomes of DAAs therapy, was created. Median values of MELD score and alpha-fetoprotein pre- and post- HCV therapy were compared by Student’s T test in order to better define the therapeutic impact of anti-HCV therapy; difference were considered statistically significant when p<0.05.
Data on the outcome of treatment was available for 55 patients (being the remaining four still on therapy). A significant decrease of α-FP levels occurred following DAAs (p<0.05). Although a reduction of MELD values was observed, a statistically significance was not reached.
Our data confirm that DAAs therapy is in general highly effective and well tolerated in real life settings, even among patients with advanced HCV-disease.

chiara valeriani
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