Kandathil, Johnanathan Wood, Fuat Kurbanov, Jeffrey Quinn, Justin Richer, Yvonne M. Higgins, Lois Eldred, Zhiping Li Background: Sustained virological response (SVR) rates with pegylated interferon (pIFN) + ribavirin (RBV) in HIV-infected men are significantly higher in acute HCV (∼65%) than in chronic HCV (∼35%), but treatment is lengthy (24-48 wks) and SVR rates

are suboptimal. We hypothesized that adding telaprevir (TVR) to pIFN+RBV would both shorten treatment and increase the SVR rates in acute HCV in HIV-infected men. Methods: This is an IRB-approved, open-label, consecutive enrollment pilot study of TVR 750 mg/8 hr + pIFN-α 180 μg/wk + weight-based RBV for 12 wks in HIV-infected men with acute gt 1 HCV infection. Stopping rule was HCV VL > 1,000 IU/mL at wk 4.Allowed ARVs were tenofovir+emtricitabine, efavirenz check details (with TVR dose adjustment), rilpivirine, atazanavir/ritonavir, and raltegravir. HCV MK-1775 price VL was measured by transcription-mediated amplification (TMA, LLOD 5 IU/mL). The comparator group was HIV-infected men with acute gt 1 HCV treated during the 3 yrs prior to the FDA approval of TVR and those ineligible for TVR. The primary endpoint, SVR 12,

is reported without statistical analysis due to the small sample sizes. Results: In the TVR-based triple therapy group, 84% (16/19) achieved the primary endpoint, SVR 12, compared to 63% (31/49) in the comparator group. Among men with SVR, the median time to VL < 5 was wk 2 in the TVR group vs wk 4 in the comparator group, and 94% vs 55% had VL < 5 by wk 4.In the TVR group there were no relapses after ETR, and 13 men (81% of SVR 12) have achieved SVR 24 so far. Two of the 3 patients in the TVR group who failed therapy had non-response

(gt 1b, white, CT; gt 1a, black, TT), and one had rebound at wk 12 (gt 1a, Hispanic, CT). Most (81%) in the TVR group received ≤ 12 weeks of therapy–3 were treated 4-8 wks and 3 were treated with an additional 12 wks pIFN+RBV–while all in the comparator group received ≥ 24 weeks of therapy. A higher percentage Histidine ammonia-lyase of men in the TVR vs comparator group had IL28B CC (63% vs 42%), which may have contributed to the higher SVR rate. No one in the TVR group had HIV VL break-through and the overall safety profile was similar to that known for the TVR+pIFN+RBV regimen. Conclusions: Incorporating TVR into treatment of acute gt 1 HCV in HIV-infected men reduced treatment duration to 12 wks in most patients while maintaining a very high SVR rate. The absence of relapses suggests that 12 wks triple therapy is sufficient if HCV VL < 5 by wk 4.Larger studies should be done to confirm these findings. Nonetheless, this triple drug regimen appears to be a substantive improvement in the treatment of acute gt 1 HCV in HIV-infected men. Disclosures: Douglas T.