Institution: | 1.Department of Medicine I,Bonn University Hospital,Bonn,Germany;2.MiB,Berlin,Germany;3.Medical University of Vienna,Vienna,Austria;4.Infektionsmedizinisches Centrum Hamburg (ICH),Hamburg,Germany;5.Royal Free Hospital,London,UK;6.Chelsea and Westminster Hospital,London,UK;7.Center for HIV and Hepatogastroenterology,Düsseldorf,Germany;8.Infektiologikum,Frankfurt/Main,Germany;9.Praxis Ebertplatz,Cologne,Germany;10.Inserm U943, UPMC-Paris06 UMR S943,Paris,France;11.AP-HP, H?pital La Pitié Salpétrière,Paris,France |
Abstract: | PurposeWith DAAs still only being licensed for chronic HCV infection, the ongoing epidemic of acute hepatitis C (AHC) infection among MSM highlights the need to identify factors allowing for optimal HCV treatment outcome.Methods303 HIV-infected patients from 4 European countries with diagnosed acute HCV infection were treated early with pegylated interferon (pegIFN) and ribavirin (RBV) (n = 273) or pegylated interferon alone (n = 30).ResultsAll patients were male, median age was 39 years. Main routes of transmission were MSM (95 %) and IVDU (3 %). 69 % of patients were infected with HCV GT 1, 4.3 % with GT 2, 10.6 % with GT 3, 16.1 % with GT 4. Overall SVR rate was 69.3 % (210/303). RVR (p ≤ 0.001), 48-w treatment duration (p ≤ 0.001) and GT 2/3 (p = 0.024) were significantly associated with SVR. SVR rates were significantly higher in HCV GT 2/3 receiving pegIFN and RBV (33/35) when compared with pegIFN mono-therapy (6/10) (94 % vs. 60 % respectively; p = 0.016). In multivariate analysis, pegIFN/RBV combination therapy (p = 0.017) and rapid virological response (RVR) (p = 0.022) were significantly associated with SVR in HCV GT 2/3. In HCV GT 1/4, RVR (p ≤ 0.001) and 48-w treatment duration (p ≤ 0.001) were significantly associated with SVR.ConclusionsTreatment of AHC GT 2 and 3 infections with pegIFN/RBV is associated with higher SVR rates suggesting different cure rates depending on HCV genotype similar to the genotype effects seen previously in chronic HCV under pegIFN/RBV. With pegIFN/RBV still being the gold standard of AHC treatment and in light of cost issues around DAAs and very limited licensed interferon-free DAA treatment options for chronic HCV GT 3 infection AHC GT 3 patients might benefit most from early interferon-containing treatment. |