Updated guidelines for managing hiv hcv co infection
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Updated Guidelines for Managing HIV/HCV Co-Infection. John J Faragon , PharmD , BCPS, AAHIV-P Regional Pharmacy Director, NY/NJ AIDS Education and Training Center Pharmacist, HIV Medicine, Albany Medical Center. www.hcvguidelines.org Released 1/29/14!. Abbreviations. BOC – boceprevir

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Updated Guidelines for Managing HIV/HCV Co-Infection

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Updated Guidelines for Managing HIV/HCV Co-Infection

John J Faragon, PharmD, BCPS, AAHIV-P

Regional Pharmacy Director,

NY/NJ AIDS Education and Training Center

Pharmacist, HIV Medicine, Albany Medical Center


www.hcvguidelines.orgReleased 1/29/14!


Abbreviations

  • BOC – boceprevir

  • DAA – direct acting antiviral

  • IFN – interferon

  • PEG – pegylated interferon

  • RBV WB – ribavirin, weight based dosing

  • RGT – response guided therapy

  • SMV – simeprevir

  • SOF – sofosbuvir

  • TVR – telaprevir

www.hcvguidelines.org


IFN Ineligible Definitions

  • Intolerance to IFN

  • Autoimmune hepatitis and other autoimmune disorders

  • Hypersensitivity to PEG or any of its components

  • Decompensated hepatic disease

  • History of depression, or clinical features consistent with depression

  • A baseline neutrophil count below 1500/μL, a baseline platelet count below 90,000/μL or baseline hemoglobin below 10 g/dL

  • A history of preexisting cardiac disease

www.hcvguidelines.org


Standard Dosing

  • Sofosbuvir – 400mg once daily

  • Simeprevir – 150mg once daily

  • Peg Interferon – 180mcg once weekly

  • Ribavirin – weight based dosing

    • <75kg – 1000mg daily in divided doses

    • ≥75 kg – 1200mg daily in divided doses

www.hcvguidelines.org


Drug Interactions Considerations

  • Sofosbuvir

    • Substrate for P-glycoprotein and breast cancer resistance protein

    • Intracellular metabolism mediated by hydrolase and nucleotide phosphorylation pathways

    • Minimal drug interactions expected

  • Simeprevir

    • Mild inhibitor of CYP1A2 activity and intestinal CYP3A4

    • Does not affect hepatic CYP3A4 activity

    • Inhibits OATP1B1/3 and P-glycoprotein

    • Multiple drug interactions expected

www.hcvguidelines.org


Sofosbuvir and HIV Medications (1 of 2)

www.nynjaetc.org


Sofosbuvir and HIV Medications (2 of 2)

www.nynjaetc.org


Simeprevir and HIV Medications (1 of 2)

www.nynjaetc.org


Simeprevir and HIV Medications (2 of 2)

www.nynjaetc.org


HIV/HCV Co-Infection, GT1

www.hcvguidelines.org


HIV/HCV Co-Infection, GT2

www.hcvguidelines.org


HIV/HCV Co-Infection, GT3

www.hcvguidelines.org


HIV/HCV Coinfection, GT4

www.hcvguidelines.org


HIV/HCV Coinfection, GT 5,6

www.hcvguidelines.org


HIV/HCV NOT Recommended

www.hcvguidelines.org


Other Drug Interactions with Sofosbuvir

www.nynjaetc.org


Other Drug Interactions with Simeprevir (1 of 2)

www.nynjaetc.org


Other Drug Interactions with Simeprevir (2 of 2)

www.nynjaetc.org


Select HIV/HCV Resources


www.nynjaetc.org


www.nynjaetc.org

CLICK HERE


www.nynjaetc.org

CLICK HERE


NY/NJ AETC – www.nynjaetc.org


NY/NJ AETC – www.nynjaetc.org


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