Last updated on February 2018

Short Duration Therapy of Acute Hepatitis C Genotypes 1 or 4 in HIV-infected Patients

Brief description of study

The purpose of this study is to assess the rate of sustained virological response (SVR) 12 weeks after 8-week oral treatment with grazoprevir 100mg/elbasvir 50mg (MRK-combo) in patients with acute hepatitis C genotype1 or 4 and co-infected with HIV.

Detailed Study Description

Increasing rates of acquisition of HCV in men who have sex with men (MSM), in particular in HIV-infected patients, have been reported since 2001 in Western European countries and particularly in France. Observational studies have recently reported that HIV-infected gay and bisexual men with sexually transmitted hepatitis C have shown unexpectedly rapid liver disease progression in a relatively short period of time.

It is therefore admitted that, in the absence of a spontaneous HCV clearance within 3 months of acute HCV infection, treatment should be initiated. Pegylated interferon in combination with weight-adapted ribavirin is still recommended as the treatment of choice for all HCV genotypes in an acute setting. For patients developing a rapid virologic response, treatment duration of 24 weeks is recommended. If antiviral therapy was initiated within 24 weeks after diagnosis, sustained virologic response rates of 60 to 80% have been observed at the price of a high side effects burden.

However, short course therapies with new direct acting antivirals are likely to be safer and more efficient. But their efficacy in acute hepatitis C has still to be established. To date, US- and Europe- based trials are ongoing in this setting with the association of sofosbuvir and ribavirine, sofosbuvir / ledipasvir or sofosbuvir / simeprevir, for a duration of 4, 6, 8 or 12 weeks. Preliminary results are very diverse, with SVR12 ranging from 56% to 95%. MSD has been evaluating the efficacy and safety of a double drug combination (grazoprevir + elbasvir) in HIV-infected patients which exhibits paramount efficacy and excellent tolerance in a diverse range of genotypes, including 1 and 4 HCV strains, which are those mainly encountered in the French acute HCV epidemics in MSM. This association has the potential to be used for short treatment duration especially with regards to the fact that patients will have no fibrosis at the time of treatment initiation. This MRK-combo would therefore be an ideal candidate for treating acute hep C due to GT1 or 4 in a "test and treat" approach in high-risk population such as MSM.

Clinical Study Identifier: NCT02886624

Contact Investigators or Research Sites near you

Start Over

Patrick Miailhes

CHU de Lyon
Lyon, France
  Connect »

Eric Rosenthal

CHU de Nice
Nice, France
  Connect »

Julie Bottero

H pital Saint-Antoine
Paris, France
  Connect »

Marc-Antoine Valantin

H pital La Piti -Salp tri re
Paris, France
  Connect »

Yazdan Yazdanpanah

H pital Bichat
Paris, France
  Connect »

Julie Chas

H pital Tenon
Paris, France
  Connect »