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]
 
* 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]]
  +
| 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" |
  +
| 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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| [[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" |
  +
| 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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| [[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" |
  +
| style="background:yellow" |
  +
| style="background:yellow" | C
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|-
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| [[EVG/r]]
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| style="background:green" |
  +
| style="background:green" |
  +
| style="background:green" |
  +
| style="background:green" |
  +
| 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" |
  +
| style="background:green" |
  +
| 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
  +
| style="background:green" | ND
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| style="background:green" | ND
  +
| style="background:green" | ND
  +
| style="background:green" | ND
  +
|-
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| rowspan=5 | NRTI
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| [[ABC]]
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| style="background:green" |
  +
| style="background:green" | ND
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| style="background:green" | ND
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| style="background:green" |
  +
| 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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| [[3TC]]
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| style="background:green" |
  +
| style="background:green" | ND
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| style="background:green" | ND
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| style="background:green" |
  +
| style="background:green" | ND
  +
|-
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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
  +
| style="background:green" | ND
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| style="background:green" |
  +
| style="background:green" | D
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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
   
 
== Further Reading ==
  
== Further Reading ==

Revision as of 10:36, 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

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

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