HIV-hepatitis C coinfection: Difference between revisions
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* Consult [https://www.hep-druginteractions.org/checker HEP Drug Interactions checker] |
* Consult [https://www.hep-druginteractions.org/checker HEP Drug Interactions checker] |
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* Be careful with Harvoni, which can increase levels of tenofovir, especially when GFR <60 mL/min |
* Be careful with Harvoni, which can increase levels of tenofovir, especially when GFR <60 mL/min |
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{| class="wikitable" |
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! !! !! LDV/SOF !! SOF/VEL !! ELB/GRZ !! GLE/PIB !! SOF/VEL/VOX |
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|- |
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| rowspan = 3 | PI |
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| [[ATV/r]] |
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| style="background:yellow" | A |
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| style="background:yellow" | A |
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| style="background:red" | |
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| style="background:red" | |
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| style="background:red" | |
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|- |
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| [[DRV/r]] |
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| style="background:yellow" | A |
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| style="background:yellow" | A |
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| style="background:red" | |
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| style="background:red" | |
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| style="background:yellow" | |
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|- |
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| [[LPR/r]] |
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| style="background:yellow" | A,ND |
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| style="background:yellow" | A |
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| style="background:red" | |
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| style="background:red" | |
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| style="background:red" | ND |
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|- |
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| rowspan=4 | NNRTI |
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| [[DOR]] |
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| style="background:green" | |
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| style="background:green" | ND |
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| style="background:green" | |
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| style="background:green" | ND |
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| style="background:green" | ND |
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|- |
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| [[EFZ]] |
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| style="background:green" | |
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| style="background:red" | |
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| style="background:red" | |
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| style="background:red" | ND |
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| style="background:red" | ND |
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|- |
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| [[RPV]] |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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|- |
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| [[ETR]] |
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| style="background:green" | ND |
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| style="background:red" | ND |
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| style="background:red" | ND |
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| style="background:red" | ND |
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| style="background:red" | ND |
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|- |
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| rowspan=4 | INSTI |
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| [[BIC]] |
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| style="background:green" | |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | |
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|- |
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| [[EVG/c]] |
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| style="background:yellow" | C |
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| style="background:yellow" | C |
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| style="background:red" | |
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| style="background:yellow" | |
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| style="background:yellow" | C |
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|- |
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| [[EVG/r]] |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | ND |
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|- |
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| [[RTG]] |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | ND |
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|- |
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| EI |
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| [[MVC]] |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | ND |
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|- |
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| rowspan=5 | NRTI |
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| [[ABC]] |
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| style="background:green" | |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | |
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| style="background:green" | ND |
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|- |
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| [[FTC]] |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:green" | |
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|- |
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| [[3TC]] |
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| style="background:green" | |
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| style="background:green" | ND |
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| style="background:green" | ND |
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| style="background:green" | |
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| style="background:green" | ND |
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|- |
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| [[TDF]] |
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| style="background:yellow" | B,C |
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| style="background:yellow" | B,C |
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| style="background:green" | |
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| style="background:green" | |
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| style="background:yellow" | C,D |
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|- |
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| [[TAF]] |
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| style="background:green" | D |
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| style="background:green" | D |
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| style="background:green" | ND |
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| style="background:green" | |
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| style="background:green" | D |
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|} |
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* '''Green''' = safe; '''yellow''' = dose change or close monitoring; '''red''' = avoid |
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* '''ND''' = no data; '''A''' = caution with TDF only; '''B''' = increase in tenofovir possible; '''C''' = avoid TDF with eGFR < 60 mL/min; '''D''' = studied in fixed-dose combinations only |
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== Further Reading == |
== Further Reading == |
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Revision as of 14:36, 16 July 2020
Principles
- Confirm both diagnoses, including ensuring HCV RNA is still positive 6 months after first measured
- Treat the HIV first, using any first-line regimen
- Treat the HIV for at least 2 weeks before starting HCV treatment
Regimens
- Consult HEP Drug Interactions checker
- Be careful with Harvoni, which can increase levels of tenofovir, especially when GFR <60 mL/min
| LDV/SOF | SOF/VEL | ELB/GRZ | GLE/PIB | SOF/VEL/VOX | ||
|---|---|---|---|---|---|---|
| PI | ATV/r | A | A | |||
| DRV/r | A | A | ||||
| LPR/r | A,ND | A | ND | |||
| NNRTI | DOR | ND | ND | ND | ||
| EFZ | ND | ND | ||||
| RPV | ||||||
| ETR | ND | ND | ND | ND | ND | |
| INSTI | BIC | ND | ND | ND | ||
| EVG/c | C | C | C | |||
| EVG/r | ND | |||||
| RTG | ND | |||||
| EI | MVC | ND | ND | ND | ND | ND |
| NRTI | ABC | ND | ND | ND | ||
| FTC | ||||||
| 3TC | ND | ND | ND | |||
| TDF | B,C | B,C | C,D | |||
| TAF | D | D | ND | D |
- Green = safe; yellow = dose change or close monitoring; red = avoid
- ND = no data; A = caution with TDF only; B = increase in tenofovir possible; C = avoid TDF with eGFR < 60 mL/min; D = studied in fixed-dose combinations only
Further Reading
- "Considerations for Antiretroviral Use in Patients with Coinfections", in Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. AIDSinfo.
- "Patients With HIV/HCV Coinfection", in HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. IDSA & AASLD.
