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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. 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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  1. 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

  2. www.hcvguidelines.orgReleased 1/29/14!

  3. 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

  4. 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

  5. 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

  6. 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

  7. Sofosbuvir and HIV Medications (1 of 2) www.nynjaetc.org

  8. Sofosbuvir and HIV Medications (2 of 2) www.nynjaetc.org

  9. Simeprevir and HIV Medications (1 of 2) www.nynjaetc.org

  10. Simeprevir and HIV Medications (2 of 2) www.nynjaetc.org

  11. HIV/HCV Co-Infection, GT1 www.hcvguidelines.org

  12. HIV/HCV Co-Infection, GT2 www.hcvguidelines.org

  13. HIV/HCV Co-Infection, GT3 www.hcvguidelines.org

  14. HIV/HCV Coinfection, GT4 www.hcvguidelines.org

  15. HIV/HCV Coinfection, GT 5,6 www.hcvguidelines.org

  16. HIV/HCV NOT Recommended www.hcvguidelines.org

  17. Other Drug Interactions with Sofosbuvir www.nynjaetc.org

  18. Other Drug Interactions with Simeprevir (1 of 2) www.nynjaetc.org

  19. Other Drug Interactions with Simeprevir (2 of 2) www.nynjaetc.org

  20. Select HIV/HCV Resources

  21. www.nynjaetc.org

  22. www.nynjaetc.org CLICK HERE

  23. www.nynjaetc.org CLICK HERE

  24. NY/NJ AETC – www.nynjaetc.org

  25. NY/NJ AETC – www.nynjaetc.org

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