Doherty Institute - Research Publications

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    Efficacy and Safety of Glecaprevir/Pibrentasvir in Patients Coinfected With Hepatitis C Virus and Human Immunodeficiency Virus Type 1: The EXPEDITION-2 Study
    Rockstroh, JK ; Lacombe, K ; Viani, RM ; Orkin, C ; Wyles, D ; Luetkemeyer, AF ; Soto-Malave, R ; Flisiak, R ; Bhagani, S ; Sherman, KE ; Shimonova, T ; Ruane, P ; Sasadeusz, J ; Slim, J ; Zhang, Z ; Samanta, S ; Ng, TI ; Gulati, A ; Kosloski, MP ; Shulman, NS ; Trinh, R ; Sulkowski, M (OXFORD UNIV PRESS INC, 2018-10-01)
    BACKGROUND: Once-daily glecaprevir coformulated with pibrentasvir (glecaprevir/pibrentasvir) demonstrated high rates of sustained virologic response 12 weeks after treatment (SVR12) in patients with hepatitis C virus (HCV) genotype 1-6 infection. This phase 3 study evaluated the efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV genotype 1-6 and human immunodeficiency virus type 1 (HIV-1) coinfection, including patients with compensated cirrhosis. METHODS: EXPEDITION-2 was a phase 3, multicenter, open-label study evaluating glecaprevir/pibrentasvir (300 mg/120 mg) in HCV genotype 1-6/HIV-1-coinfected adults without and with compensated cirrhosis for 8 and 12 weeks, respectively. Patients were either HCV treatment-naive or experienced with sofosbuvir, ribavirin, or interferon, and antiretroviral therapy (ART) naive or on a stable ART regimen. Treatment-experienced genotype 3-infected patients were excluded. The primary endpoint was the SVR12 rate. RESULTS: In total, 153 patients were enrolled, including 16 (10%) with cirrhosis. The SVR12 rate was 98% (n = 150/153; 95% confidence interval, 95.8-100), with no virologic failures in 137 patients treated for 8 weeks. One genotype 3-infected patient with cirrhosis had on-treatment virologic failure. Most adverse events were mild in severity; 4 patients (2.6%) had serious adverse events, all deemed unrelated to glecaprevir/pibrentasvir. Treatment discontinuation was rare (<1%). All patients treated with ART maintained HIV-1 suppression (<200 copies/mL) during treatment. CONCLUSIONS: Glecaprevir/pibrentasvir for 8 weeks in noncirrhotic and 12 weeks in cirrhotic patients is a highly efficacious and well-tolerated treatment for HCV/HIV-1 coinfection, regardless of baseline HCV load or prior treatment with interferon or sofosbuvir. CLINICAL TRIAL REGISTRATION: NCT02738138.
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    Cell-associated HIV RNA and the ratio of HIV RNA to DNA have circadian cycles in HIV-positive individuals on antiretoviral therapy
    Stern, J ; Roche, M ; Solomon, A ; Dantanarayana, A ; Reynaldi, A ; Davenport, MP ; Deeks, SG ; Hartogenesis, W ; Hecht, FM ; Cockerham, L ; Lewin, SR (JOHN WILEY & SONS LTD, 2019-07)