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Sofosbuvir/velpatasvir, a forthcoming combination that effectively treats all hepatitis C virus (HCV) genotypes, can be safely used with most boosted antiretrovirals for people with HIV and HCV co-infection, according to a study presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016) last week in Boston.
About one-third of people living with HIV also have HCV. New direct-acting antivirals (DAAs) used in interferon-free regimens can successfully treat hepatitis C in people with HIV and most experts no longer consider people with co-infection to be a ‘difficult-to-treat’ population. But it is important to avoid combining DAAs and antiretroviral agents that interact with each other, which could lead to either high drug levels that worsen side-effects or low levels that are not as effective.
A coformulation containing sofosbuvir (a nucleotide HCV NS5B polymerase inhibitor) and velpatasvir (a pan-genotypic HCV NS5A inhibitor) was shown to be highly effective against HCV genotypes 1 through 6 in the phase 3 ASTRAL trials. It is currently undergoing evaluation by the European Medicines Agency and priority review by the US Food and Drug Administration, with a decision expected in late June.