Incident Hepatitis C Virus Infections in the Swiss HIV Cohort Study: Changes in Treatment Uptake and Outcomes Between 1991 and 2013.

Wandeler, Gilles; Schlauri, Marion; Jaquier, Marie-Eve; Rohrbach, Janine; Metzner, Karin J; Fehr, Jan; Ambrosioni, Juan; Cavassini, Matthias; Stöckle, Marcel; Schmid, Patrick; Bernasconi, Enos; Keiser, Olivia; Salazar-Vizcaya, Luisa; Furrer, Hansjakob; Rauch, Andri (2015). Incident Hepatitis C Virus Infections in the Swiss HIV Cohort Study: Changes in Treatment Uptake and Outcomes Between 1991 and 2013. Open Forum Infectious Diseases, 2(1), ofv026. Oxford University Press 10.1093/ofid/ofv026

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Background.  The hepatitis C virus (HCV) epidemic is evolving rapidly in patients infected with human immunodeficiency virus (HIV). We aimed to describe changes in treatment uptake and outcomes of incident HCV infections before and after 2006, the time-point at which major changes in HCV epidemic became apparent. Methods.  We included all adults with an incident HCV infection before June 2012 in the Swiss HIV Cohort Study, a prospective nationwide representative cohort of individuals infected with HIV. We assessed the following outcomes by time period: the proportion of patients starting an HCV therapy, the proportion of treated patients achieving a sustained virological response (SVR), and the proportion of patients with persistent HCV infection during follow-up. Results.  Of 193 patients with an HCV seroconversion, 106 were diagnosed before and 87 after January 2006. The proportion of men who have sex with men increased from 24% before to 85% after 2006 (P < .001). Hepatitis C virus treatment uptake increased from 33% before 2006 to 77% after 2006 (P < .001). Treatment was started during early infection in 22% of patients before and 91% after 2006 (P < .001). An SVR was achieved in 78% and 29% (P = .01) of patients treated during early and chronic HCV infection. The probability of having a detectable viral load 5 years after diagnosis was 0.67 (95% confidence interval [CI], 0.58-0.77) in the group diagnosed before 2006 and 0.24 (95% CI, 0.16-0.35) in the other group (P < .001). Conclusions.  In recent years, increased uptake and earlier initiation of HCV therapy among patients with incident infections significantly reduced the proportion of patients with replicating HCV.

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
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Wandeler, Gilles; Rohrbach, Janine; Keiser, Olivia; Salazar, Luisa Paola; Furrer, Hansjakob and Rauch, Andri

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 570 Life sciences; biology

ISSN:

2328-8957

Publisher:

Oxford University Press

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

11 Jun 2015 16:51

Last Modified:

31 May 2016 14:16

Publisher DOI:

10.1093/ofid/ofv026

PubMed ID:

26034775

Additional Information:

Wandeler, Schlauri & Jaquier contributed equally to this work.

Uncontrolled Keywords:

acute HCV; treatment outcomes; treatment uptake

BORIS DOI:

10.7892/boris.69377

URI:

https://boris.unibe.ch/id/eprint/69377

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