TY - JOUR T1 - Efficacy of Elbasvir/Grazoprevir in Early Chronic G1/G4 Hepatitis C infection in HIV/HCV co-infected patients with mild fibrosis JO - Gastroenterología y Hepatología T2 - AU - Laguno Centeno,Montserrat AU - Alvarez,Beatriz AU - Martínez-Rebollar,Maria AU - de la Mora,Lorena AU - Prieto,Laura AU - de Lazzari,Elisa AU - González-Cordón,Ana AU - Torres,Berta AU - Cabello,Alfonso AU - Gorgolas,Miguel AU - Mallolas,Josep SN - 02105705 M3 - 10.1016/j.gastrohep.2020.06.019 DO - 10.1016/j.gastrohep.2020.06.019 UR - https://www.elsevier.es/es-revista-gastroenterologia-hepatologia-14-articulo-efficacy-elbasvir-grazoprevir-in-early-chronic-S0210570520302806 AB - BackgroundAcute hepatitis C virus (AHC) infection is increasingly common among HIV+ men who have sex with men (MSM). Until 2017, the guidelines recommended therapy with pegylated-interferon plus ribavirin with a mild sustained virological response (SVR). This prompted many patients to reject that treatment, at that time, waiting to be treated with better and safer options with new Direct-Acting-Antivirals (DAA). ObjectivesAssess the efficacy and safety of Elbasvir/Grazoprevir to treat recent chronic hepatitis C infection, genotype 1 or 4, in HIV+ MSM patients. MethodsProspective, open-labeled, two center, pilot study. SVR is analyzed for treatment with Elbasvir/Grazoprevir (8 weeks in GT1b or 12 in GT1a or GT4) in patients with a recent chronic HCV infection, defined as HCV infection lasting less than 4 years and mild liver fibrosis (liver stiffness <8kPa). ResultsForty-eight patients were included (May 2017–March 2018): 2 GT1b, 24 GT1a and 22 GT4. HCV-RNA>800000UI in 63% and medium liver stiffness 4.9kPa. The SVR was 98%, one patient failed due to poor adherence. 67% of patients had adverse effects, but only 16% treatment related. The most frequent side effects were gastrointestinal (19%), related with the central nervous system (18%), respiratory (16%) and systemic symptoms (15%).During one year of follow-up post-therapy, 4 AHC and 18 patients with sexually transmitted diseases (STD) were diagnosed. ConclusionsTreatment with Elbasvir/Grazoprevir in this scenario is highly effective and safe. Patients with risky sexual practices must remain linked to the medical care system to detect new STD and HCV reinfection. ER -