Wien Klin Wochenschr (2017) 129:517–526
Progress in eradication of HCV in HIV positive patients with
signiﬁcant liver ﬁbrosis in Vienna
Sebastian Steiner · Theresa Bucsics · Philipp Schwabl · Mattias Mandorfer · Bernhard Scheiner ·
Maximilian Christopher Aichelburg · Katharina Grabmeier-Pﬁstershammer · Peter Ferenci · Michael Trauner ·
Markus Peck-Radosavljevic · Thomas Reiberger
Received: 18 August 2016
Accepted: 19 December 2016
Published online: 27 January 2017
© The Author(s) 2017. This article is available at SpringerLink with Open Access.
Aim We aimed to investigate the efﬁcacy of interferon
and ribavirin-free sofosbuvir/ledipasvir (SOF/LDV)
and ritonavir boosted paritaprevir/ombitasvir with
or without dasabuvir (2D/3D) regimens in a real-life
cohort of human immunodeﬁciency virus/hepatitis
C virus (HIV/HCV) coinfected patients. The study
focused on efﬁcacy, need for changes in antiretroviral
therapy (ART) due to drug-drug interaction (DDI),
and treatment-associated changes in liver stiffness.
Methods In this study 36 patients (n =21SOF/LDV
and n = 15 2D/3D) were retrospectively analyzed.
Depending on the genotype the following treatment
regimens were used: HCV genotype (GT)-1: either
SOF/LDV or 3D, no patient with HCV-GT2 was in-
cluded, HCV-GT3: SOF/LDV, HCV-GT4: 2D.
Results Approximately one third (35.3%) of patients
were treatment-experienced and 13.9% had cirrhosis.
Antiretroviral therapy had to be changed in 38.1%
S. Steiner · T. Bucsics, M.D. · P. Schwabl, M.D. ·
M. Mandorfer, M.D. · B. Scheiner, M.D. · P. Ferenci, M.D. ·
M. Trauner, M.D. · M. Peck-Radosavljevic, M.D. ·
T. Reiberger, M.D. (
Division of Gastroenterology and Hepatology, Department
of Internal Medicine III, Medical University of Vienna,
Waehringer Guertel 18–20, 1090 Vienna, Austria
M. C. Aichelburg, M.D. · K. Grabmeier-Pﬁstershammer, M.D.
Division of Immunology, Allergy and Infectious Diseases,
Department of Dermatology, Medical University of Vienna,
S. Steiner · T. Bucsics, M.D. ·
K. Grabmeier-Pﬁstershammer, M.D. ·
M. Peck-Radosavljevic, M.D. · T. Reiberger, M.D.
Vienna HIV & Liver Study Group, Vienna, Austria
of SOF/LDV and 60% of 2D/3D patients prior to
anti-HCV treatment due to expected DDIs. We ob-
served sustained virologic response (SVR) rates of
100% in patients treated with SOF/LDV (19/19) and
2D/3D (14/14). One 2D/3D patient was lost to follow-
up, while two SOF/LDV patients died during ther-
apy from non-treatment-related causes. They were
excluded from the analysis. Between baseline and fol-
low-up liver stiffness decreased from 11.4 to 8.3 kPa
(p = 0.008) and from 8.1 to 5.7 kPa (p = 0.001) in
SOF/LDV and 2D/3D patients, respectively.
Conclusions We conﬁrmed the excellent HCV erad-
ication rates >95% in a real-life cohort of HIV/HCV
coinfected patients treated with SOF/LDV and 2D/3D.
We observed no HCV relapse or breakthrough. More
patients treated with 2D/3D required a change in ART
than patients treated with SOF/LDV. Additionally, HCV
eradication led to a rapid decline in liver stiffness.
Keywords HIV · Hepatitis C virus · Sofosbuvir · Ledi-
pasvir · 3D
Chronic hepatitis C virus (HCV) infections are esti-
mated to affect 0.3% of the overall population in Aus-
tria; however, only one third of patients are aware
of their infection . According to the Joint United
Nations Programme on HIV/AIDS (UNAIDS) approx-
imately 9000 people in Austria are living with human
immunodeﬁciency virus (HIV) . Of those approxi-
mately 20% are coinfected with HCV . Liver-related
mortality, mainly due to viral hepatitis, remains a ma-
jor cause of death amongst HIV-positive individuals
. When compared with HCV mono-infected pa-
tients, HIV/HCV coinfected patients progress faster to
cirrhosis  and show increased liver-related mortal-
ity [6, 7]. Since eradication of HCV improves overall
Progress in eradication of HCV in HIV positive patients with signiﬁcant liver ﬁbrosis in Vienna 517