Aim:
To study and compare the efficacy of different regimens of combination antiviral therapy for hepatitis C and B in achieving a sustained virological response in patients with HIV/HBV/HCV coinfection and their impact on the degree of liver fibrosis.

Material and methods:
We examined 113 HIV-infected adult patients with HBV/HCV coinfection who were registered at the Municipal Non-profit Enterprise “Infectious Diseases Center of the Ivano-Frankivsk Regional Council” between 2017 and 2019.

Results:
The treatment regimens with two direct-acting antivirals (sofosbuvir/ledipasvir, sofosbuvir+daclatasvir, sofosbuvir/velpatasvir and sofosbuvir/ledipasvir and ribavirin resulted in 100 % sustained virologic response. The efficacy of the pegylated interferon, sofosbuvir, and ribavirin regimen was lower, with sustained virologic response achieved in 86.2 % of patients. The lowest efficacy was observed with the sofosbuvir and ribavirin regimen – sustained virologic response achieved in 75.0 % of patients. Primary HBV resistance to tenofovir/emtricitabine was identified in 1.76 % of patients in the entire cohort. Among patients in the group treated with combined antiviral therapy for HBV and HCV using tenofovir/emtricitabine and direct-acting antivirals with or without ribavirin, the incidence of liver fibrosis F3-F4, as assessed by point-shear wave elastography, decreased from 20 % to 2.5 % (р<0,05) after one year of follow-up.

Conclusions:
In patients with HIV/HBV/HCV coinfection, interferon-free regimens that include two direct-acting antivirals, either alone or in combination with ribavirin, demonstrated 100 % virologic efficacy and the most beneficial effects on the liver reducing the degree of liver fibrosis.