Rates of sustained virological response (SVR) among patients with HIV and HCV coinfection in Hep-CAUSAL estimated SVR rates of approximately 95% with and without adjustment for missing HCV RNA testing, which are consistent with clinical trial results, according to findings published in the Journal of the International AIDS Society. Sara Lodi, PhD, and colleagues examined 4,527 individuals who started treatment with direct acting antivirals (DAAs) between 2014 and 2020 (88% men; median age, 56). Among 642 individuals (14%) with no HCV RNA test results at 12 weeks or more since the end of treatment, the overall observed and g-formula imputed SVR rates were 93% and 94%, respectively. SVR estimates were similarly high across all strata. “A substantial proportion of individuals who received DAA treatment were never assessed for SVR post-DAA, and strategies for more systematic routine HCV RNA testing should be considered,” Dr. Lodi and colleagues wrote.
USPSTF Recommends PrEP for Reducing HIV Risk
The US Preventive Services Task Force (USPSTF) recommends PrEP for reducing the risk for HIV among individuals at increased risk for HIV acquisition, according to a statement issued by USPSTF. Roger Chou, MD, and colleagues conducted a systematic review on the effects of PrEP on the risk for HIV acquisition, mortality, harms, and other clinical outcomes. In 11 trials involving
populations at higher risk for HIV infection, oral PrEP was associated with a reduced risk versus placebo or no PrEP (relative risk, 0.46). The effects were consistent across HIV risk categories and for tenofovir disoproxil fumarate (TDF) plus emtricitabine or TDF alone. A strong association was seen between higher adherence and greater efficacy (relative risks, 0.27 for ≥70% adherence, 0.51 for >40% to <70% adherence, and 0.93 for ≤40% adherence). The risk for serious adverse events, STDs, or adverse pregnancy outcomes did not differ for PrEP versus placebo/no PrEP. Based on these findings, the USPSTF recommends prescribing PrEP to
adolescents and adults at increased risk for HIV (A recommendation).
