Simultaneous TB/HCV treatment

By Svetlana Degtyareva | 06 Jun, 2018

Dear colleagues!
Does anyone of you have an experience of simultaneous treatment of a patient with anti-tuberculous and direct acting antiviral drugs for HCV-infection?
What are the official approaches in your country to this problem?
 In case of drug-susceptible TB is it possible to treat a patient first of all for HCV, especially in case of high risk of hepatotoxicity?

All the best.
Degtyareva Svetlana

Replies

 

Tom Yates Replied at 1:17 PM, 6 Jun 2018

Hello,

I don't have experience. However, I note there is now a useful looking drug
interaction checker for the hepatitis drugs, run by the same people that
make the Liverpool HIV drug interactions tools...

https://www.hep-druginteractions.org/

Erica Lessem Replied at 3:05 PM, 6 Jun 2018

WHO HCV treatment guidance is clear on this issue: "concurrent treatment of
HCV infection and TB should be avoided. Active TB should generally be
treated before commencing therapy for HCV"

http://apps.who.int/iris/bitstream/handle/10665/205035/9789241549615_eng.pdf?...
(see section 9.7 for full text)

HOMA MANSOOR Replied at 1:33 AM, 7 Jun 2018

Hi Svetlana,

We have been treating HCV in our MSF project in India .We screen the
patient for TB before starting HCV Drugs(Oral DAAS) in order to prevent
interruption of HCV Treatment. If the patient has been diagnosed with DS TB
during screening one should treat the TB first and then treat HCV

There is a strong drug interaction between the oral DAAS and Rifampicin and
there use together is not recommended.Hence if a patient develop DSTB
during treatment of HCV one has to interrupt HCV treatment.

In case of DRTB with HCV co-infection- Luckily no known drug interaction
between second line TB drugs and DAAs ,at times it is good to treat them
together once the patient has settled down with DRTB drugs as it will
prevent added hepatotoxicity due to HCV Infection.

Bisimwa Nsibula Replied at 12:59 PM, 7 Jun 2018

Thanks for idea and it will be good to have good survey for save persons needed treatment

Karuppan Narayanan Replied at 6:40 AM, 8 Jun 2018

Dear sir/Madam
SARC trust is a non profit Indian NGO.i have apply for project proposal .
Thanking you
K.Narayanan

Attached resource:

Svetlana Degtyareva Replied at 7:38 AM, 8 Jun 2018

Thank you all for highly useful information and links!

Do you know about any researches concerning non-inferiority of combined MDR-TB and anti-HCV treatment comparing to patients with monoinfection? Do they exist?