Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study.

Béguelin, Charles Antoine; Suter, Annatina; Bernasconi, Enos; Fehr, Jan; Kovari, Helen; Bucher, Heiner C; Stoeckle, Marcel; Cavassini, Mathias; Rougemont, Mathieu; Schmid, Patrick; Wandeler, Gilles; Rauch, Andri (2018). Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study. Liver international, 38(3), pp. 424-431. Blackwell Munksgaard 10.1111/liv.13528

[img] Text
Béguelin LiverInt 2017.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (447kB) | Request a copy
[img]
Preview
Text
B-guelin_et_al-2017-Liver_International.pdf - Accepted Version
Available under License Publisher holds Copyright.

Download (556kB) | Preview

BACKGROUND & AIMS Hepatitis C virus (HCV) therapies with interferon-free second-generation direct-acting antiviral agents (DAAs) are highly effective and well tolerated. They have the potential to increase treatment eligibility and efficacy in HIV-infected patients. We assessed the impact of DAAs on treatment uptake, efficacy as well as its impact on the burden of liver disease in the Swiss HIV Cohort Study (SHCS). METHODS We describe clinical and virological characteristics of patients treated with second generation DAAs. We compared treatment incidence, sustained virological response (SVR)12 and liver fibrosis stages between three time periods: period 1, 01/2009-08/2011 (prior to the availability of DAAs); period 2, 09/2011-03/2014 (first generation DAAs); period 3, 04/2014-12/2015 (second generation DAAs). RESULTS At the beginning of the third period, 876 SHCS participants had a chronic HCV infection of whom 180 (20%) started treatment with a second generation DAA. Three- quarters of them had advanced liver fibrosis (Metavir≥3) of whom 80% were cirrhotics. SVR12 was achieved in 173/180 (96%) patients, 3 patients died and 4 experienced a virological failure. Over the three time periods, treatment uptake (4.5/100py, 5.7/100py, 22.4/100py) and efficacy (54%, 70%, 96% SVR12) continuously increased. The number of cirrhotic patients with replicating HCV infection in the SHCS declined from 25% at the beginning to 12% at the end of the last period. CONCLUSIONS After the introduction of second generation DAAs we observed an increase in treatment uptake and efficacy which resulted in a significant reduction in the number of cirrhotic patients with replicating HCV infection in the SHCS. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Béguelin, Charles Antoine; Wandeler, Gilles and Rauch, Andri

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

1478-3223

Publisher:

Blackwell Munksgaard

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

05 Sep 2017 11:57

Last Modified:

26 Jul 2018 02:30

Publisher DOI:

10.1111/liv.13528

PubMed ID:

28741901

Uncontrolled Keywords:

DAA ; Fibrosis; HCV treatment; long-term trends; uptake and efficacy

BORIS DOI:

10.7892/boris.102456

URI:

https://boris.unibe.ch/id/eprint/102456

Actions (login required)

Edit item Edit item
Provide Feedback