Fatal Relapse of Myelodysplastic Syndrome in a Patient with HIV/Hepatitis C Coinfection Treated with Simeprevir/Sofosbuvir

• Published in: Journal of the International Association of Providers of AIDS Care Vol. 16; no. 2; pp. 114 - 116
• Main Authors: Diejomaoh, Efemena Michael, Gathe, Joseph Clayton, Mayberry, Carl Craig, Clemmons, John Benjamin, Miguel, Bernie, Glombicki, Alan, Daquioag, Benjamin
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.03.2017; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Antiviral Agents - therapeutic use; Antiviral drugs; Blood diseases; Cancer; Coinfection; Fatal Outcome; Hepatitis; Hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; HIV; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Interferon; Kidney cancer; Male; Middle Aged; Myelodysplastic syndromes; Myelodysplastic Syndromes - complications; Patients; Prostate cancer; Recurrence; Relapse; Ribavirin - therapeutic use; Simeprevir - therapeutic use; Sofosbuvir - therapeutic use; Sustained Virologic Response; HIV/hepatitis C; ribavirin; SVR-12; simeprevir/sofosbuvir; myelodysplastic syndrome
• ISSN: 2325-9582; 2325-9574; 2325-9582
• DOI: 10.1177/2325957416686837

Registrational studies and observational cohorts clearly suggest sustained virologic response (SVR) rates in HIV-/hepatitis C–coinfected patients are similar to monoinfected patients when utilizing interferon-free regimens, and this can be accomplished with agents that are well tolerated with minimal adverse events. These randomized trials that led to the approval of several of our new direct-acting antiviral agents, however, specifically excluded patients who had significant comorbidities and none to our knowledge accepted patients with a history of cancer. Therefore, the effect of treatment of active hepatitis C in such patients and the effect on preexisting neoplasia are relatively unknown. We prospectively followed a 62-year-old male coinfected with HIV/hepatitis C who had a history of anal squamous cell carcinoma, prostate carcinoma, renal cell carcinoma all clinically cured and a myelodysplastic syndrome that was in remission. The patient achieved an SVR of hepatitis C with simeprevir/sofosbuvir without ribavirin and died shortly thereafter of a fatal relapse of his previously clinically controlled myelodysplastic syndrome.