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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

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

abbreviations
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
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
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
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

hiv hcv co infection gt1
HIV/HCV Co-Infection, GT1

www.hcvguidelines.org

hiv hcv co infection gt2
HIV/HCV Co-Infection, GT2

www.hcvguidelines.org

hiv hcv co infection gt3
HIV/HCV Co-Infection, GT3

www.hcvguidelines.org

hiv hcv coinfection gt4
HIV/HCV Coinfection, GT4

www.hcvguidelines.org

hiv hcv coinfection gt 5 6
HIV/HCV Coinfection, GT 5,6

www.hcvguidelines.org

hiv hcv not recommended
HIV/HCV NOT Recommended

www.hcvguidelines.org

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