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Factors associated with DAA virological treatment failure and resistance-associated substitutions description in HIV/HCV coinfected patients

Abstract : AIM To describe factors associated with treatment failure and frequency of resistance-associated substitutions (RAS). METHODS Human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients starting a first direct-acting antiviral (DAA) regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defined as: (1) non-response [HCV-RNA remained detectable during treatment, at end of treatment (EOT)]; and (2) relapse (HCV-RNA suppressed at EOT but detectable thereafter). Sequencing analysis was performed to describe prevalence of drug class-specific RAS. Factors associated with failure were determined using logistic regression models. RESULTS Among 559 patients, 77% had suppressed plasma HIV-RNA < 50 copies/mL at DAA treatment initiation, 41% were cirrhotic, and 68% were HCV treatment-experienced. Virological treatment failures occurred in 22 patients and were mainly relapses (17, 77%) then undefined failures (3, 14%) and non-responses (2, 9%). Mean treatment duration was 16 wk overall. Post-treatment NS3, NS5A or NS5B RAS were detected in 10/14 patients with samples available for sequencing analysis. After adjustment for age, sex, ribavirin use, HCV genotype and treatment duration, low platelet count was the only factor significantly associated with a higher risk of failure (OR: 6.5; 95%CI: 1.8-22.6). CONCLUSION Only 3.9% HIV-HCV coinfected patients failed DAA regimens and RAS were found in 70% of those failing. Low platelet count was independently associated with virological failure.
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https://hal-amu.archives-ouvertes.fr/hal-02146873
Contributor : Jean-Charles Dufour <>
Submitted on : Tuesday, June 4, 2019 - 11:49:22 AM
Last modification on : Tuesday, June 2, 2020 - 6:58:03 PM

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Dominique Salmon, Pascale Trimoulet, Camille Gilbert, Caroline Solas, Eva Lafourcade, et al.. Factors associated with DAA virological treatment failure and resistance-associated substitutions description in HIV/HCV coinfected patients. World Journal of Hepatology, 2018, 10 (11), pp.856-866. ⟨10.4254/wjh.v10.i11.856⟩. ⟨hal-02146873⟩

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