Telaprevir Improves Treatment Outcomes for HIV/HCV Coinfected People

[Guest guest]

Telaprevir Improves Treatment

Outcomes for HIV/HCV Coinfected People

By Liz Highleyman

SUMMARY: The experimental hepatitis C virus (HCV) protease inhibitor telaprevir,

combined with pegyalted interferon plus ribavirin, reduced HCV viral load to

undetectable levels in about 70% of HIV positive patients at weeks 4 and 12 in

the first study of the drug in HIV/HCV coinfected people. Based on these eagerly

awaited Phase 2 results, presented this week at the 18th Conference on

Retroviruses and Opportunistic Infections (CROI 2011) in Boston, Vertex

Pharmaceuticals plans to start a Phase 3 coinfection study later this year.

, Stefan Zeuzem, and Mark Sulkowski

(Photo: Liz Highleyman)

HIV positive people coinfected with HCV tend to experience more rapid liver

disease progression than individuals with hepatitis C alone. Furthermore, some

studies -- though not all -- suggest that HIV/HCV coinfected patients do not

respond as well to standard therapy consisting of pegylated interferon plus

ribavirin.

Mark Sulkowski from s Hopkins University and colleagues reported interim

results from Study 110, a Phase 2 clinical trial comparing telaprevir vs placebo

combined with standard therapy in HIV/HCV coinfected participants not previously

treated for chronic hepatitis C.

The study was divided into 2 parts. Part A included 13 coinfected patients with

CD4 T-cell counts >500 cells/mm3 who were not yet taking antiretroviral therapy

(ART) but had HIV viral loads <100,000 copies/mL. Part B included 46 coinfected

patients with CD4 counts >300 cells/mm3 and undetectable HIV RNA (< 50

copies/mL) on 1 of 2 ART regimens:

Efavirenz plus tenofovir plus emtricitabine (the drugs in the Atripla pill)

Atazanavir (Reyataz) plus tenofovir plus either emtricitabine (Emtriva) or

lamivudine (Epivir).

As described in another CROI presentation, pharmacokinetic studies of healthy

HIV and HCV negative volunteers showed that telaprevir has modest drug-drug

interactions with several antiretroviral agents including lopinavir/ritonavir

(Kaletra), darunavir (Prezista), and fosamprenavir (Lexiva). Based on these

findings, efavirenz (Sustiva) and atazanavir were judged to be the most suitable

HIV drugs for use with telaprevir. Efavirenz lowers telaprevir blood levels, but

raising the telaprevir dose can compensate for this effect. No dose adjustment

was considered necessary with atazanavir. Full Article...

[Guest guest]

Telaprevir Improves Treatment

Outcomes for HIV/HCV Coinfected People

By Liz Highleyman

SUMMARY: The experimental hepatitis C virus (HCV) protease inhibitor telaprevir,

combined with pegyalted interferon plus ribavirin, reduced HCV viral load to

undetectable levels in about 70% of HIV positive patients at weeks 4 and 12 in

the first study of the drug in HIV/HCV coinfected people. Based on these eagerly

awaited Phase 2 results, presented this week at the 18th Conference on

Retroviruses and Opportunistic Infections (CROI 2011) in Boston, Vertex

Pharmaceuticals plans to start a Phase 3 coinfection study later this year.

, Stefan Zeuzem, and Mark Sulkowski

(Photo: Liz Highleyman)

HIV positive people coinfected with HCV tend to experience more rapid liver

disease progression than individuals with hepatitis C alone. Furthermore, some

studies -- though not all -- suggest that HIV/HCV coinfected patients do not

respond as well to standard therapy consisting of pegylated interferon plus

ribavirin.

Mark Sulkowski from s Hopkins University and colleagues reported interim

results from Study 110, a Phase 2 clinical trial comparing telaprevir vs placebo

combined with standard therapy in HIV/HCV coinfected participants not previously

treated for chronic hepatitis C.

The study was divided into 2 parts. Part A included 13 coinfected patients with

CD4 T-cell counts >500 cells/mm3 who were not yet taking antiretroviral therapy

(ART) but had HIV viral loads <100,000 copies/mL. Part B included 46 coinfected

patients with CD4 counts >300 cells/mm3 and undetectable HIV RNA (< 50

copies/mL) on 1 of 2 ART regimens:

Efavirenz plus tenofovir plus emtricitabine (the drugs in the Atripla pill)

Atazanavir (Reyataz) plus tenofovir plus either emtricitabine (Emtriva) or

lamivudine (Epivir).

As described in another CROI presentation, pharmacokinetic studies of healthy

HIV and HCV negative volunteers showed that telaprevir has modest drug-drug

interactions with several antiretroviral agents including lopinavir/ritonavir

(Kaletra), darunavir (Prezista), and fosamprenavir (Lexiva). Based on these

findings, efavirenz (Sustiva) and atazanavir were judged to be the most suitable

HIV drugs for use with telaprevir. Efavirenz lowers telaprevir blood levels, but

raising the telaprevir dose can compensate for this effect. No dose adjustment

was considered necessary with atazanavir. Full Article...