Pilot Study to Assess the Efficacy of and Tolerance to a QUadruple Therapy to Treat HIV-HCV Coinfected Patients Previously Null Responders

Exclusion Criteria

• •CHILD B and C cirrhosis, past history of decompensated cirrhosis. Patients with CHILD A cirrhosis must demonstrate the absence of significant oesophageal varices (Stages 2-3) on an upper gastrointestinal endoscopy ≤ 12 months
• •Positive HBs antigenemia with HBV DNA \> 1000 IU/ml((if positive AgHBs with HBV DNA ≤ 1000 IU/mL, patient will be included provided it is treated with Ténofovir)
• •Pregnant women, breast-feeding women
• •Refusal of adequate contraception
• •Contra-indication to Ribavirin, including hypersensitivity reaction to Ribavirin
• •Contra-indication to Peginterferon, including psychiatric contra-indications. Patients with significant psychiatric past history, notably severe depression requiring hospitalization or suicide attempt, cannot be included unless they undergo a psychiatric evaluation and obtain a specific authorization for the use of interferon.
• •Premature discontinuation (during the first six months) of a previous HCV treatment for toxicity. Patients who have stopped a previous treatment for severe anaemia or neutropenia can enter the study if erythropoietin or granulocyte growth factor had not been used during the previous treatment
• •Previous HCV therapy including HCV NS3 protease inhibitor
• •Severe pre-existing cardiac or pulmonary disease
• •History of organ transplant
• •Acute CDC stage C opportunistic infection occurring within the previouW6 months
• •Any active malignant disease including hepatocellular carcinoma for which a specific assessment is required at screening
• •Alcohol intake that may represent an obstacle for the participation of the subject in the study
• •Substance abuse that may represent an obstacle for the participation of the subject in the study. Stabilized patients included in a substitution program can participate in the study
• •Patients with previous observance problem unable to observe the study procedures
• •Participation in another clinical trial within the previous 30 days
• •Haemoglobin \< 90 g/L
• •Platelets \< 50 000 /mm3
• •Neutrophil count \< 750 /mm3
• •Renal insufficiency defined by an estimated Glomerular Filtration Rate \< 50 mL/mn (MDRD equation)
• •Absence of antiretroviral treatment or antiretroviral treatment different from the authorized combinations
• •Associated medication likely to interfere with any of the study drugs such as CPY3A4 inducers (rifampin, Millepertuis)