Uptake of HCV treatment in HIV/HCV coinfected patients across europe in the era of direct-acting antivirals.

Peters, Lars; Laut, Kamilla; Resnati, Chiara; Del Campo, Santos; Leen, Clifford; Falconer, Karolin; Trofimova, Tatyana; Paduta, Dzmitry; Gatell, Jose; Rauch, Andri; Lacombe, Karine; Domingo, Pere; Chkhartishvili, Nikoloz; Zangerle, Robert; Matulionyte, Raimonda; Mitsura, Viktar; Benfield, Thomas; Zilmer, Kai; Khromova, Irina; Lundgren, Jens; ... (2018). Uptake of HCV treatment in HIV/HCV coinfected patients across europe in the era of direct-acting antivirals. AIDS, 32(14), pp. 1995-2004. Lippincott Williams & Wilkins 10.1097/QAD.0000000000001928

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BACKGROUND AND AIMS To investigate the uptake of HCV therapy among HIV/HCV coinfected patients in the pan-European EuroSIDA study between 2011-2016. METHODS All HCV-RNA+ patients were included. Baseline was defined as latest of anti-HCV+, January 2011 or enrolment in EuroSIDA. The incidence of starting first IFN-free direct-acting antiviral (DAA) therapy was calculated. Factors associated with starting IFN-free DAA were determined by Poisson regression. RESULTS Among 4308 HCV-RNA+ patients (1255, 970, 663, 633, 787 from South, West, North, Central East and East Europe, respectively) with 11863 person years of follow up (PYFU), 1113 (25.8%) started any HCV therapy. Among patients with ≥F3 fibrosis, >50% in all regions remained untreated. The incidence (per 1000 PYFU, 95% CI) of starting DAA increased from 7.8 (5.9 - 9.8) in 2014 to 135.2 (122.0 - 148.5) in 2015 and 128.9 (113.5 - 144.3) in 2016. The increase was highest in North and West and intermediate in South, but remained modest in Central East and Eastern Europe. After adjustment, females, individuals from Central East or East, genotype 3, antiretroviral therapy naïve and those with detectable HIV-RNA were less likely to start DAA. Older persons, those with HCV-RNA >500.000 IU/ml and those with more advanced liver fibrosis were more likely to start DAA. CONCLUSIONS Uptake of DAA therapy among HIV/HCV coinfected patients increased considerably in Western Europe between 2014 and 2016, but was modest in Central East and East. In all regions more than 50% with ≥F3 fibrosis remained untreated. Women were less likely to start DAA.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Rauch, Andri

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0269-9370

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

19 Jul 2018 13:56

Last Modified:

24 Oct 2019 07:50

Publisher DOI:

10.1097/QAD.0000000000001928

PubMed ID:

29912062

BORIS DOI:

10.7892/boris.118275

URI:

https://boris.unibe.ch/id/eprint/118275

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