Modelling the impact of deferring HCV treatment on liver-related complications in HIV coinfected men who have sex with men

Zahnd, Cindy; Salazar-Vizcaya, Luisa; Dufour, Jean-François; Müllhaupt, Beat; Wandeler, Gilles; Kouyos, Roger; Estill, Janne; Bertisch, Barbara; Rauch, Andri; Keiser, Olivia (2016). Modelling the impact of deferring HCV treatment on liver-related complications in HIV coinfected men who have sex with men. Journal of hepatology, 65(1), pp. 26-32. Elsevier 10.1016/j.jhep.2016.02.030

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BACKGROUND AND AIMS Hepatitis C (HCV) is a leading cause of morbidity and mortality in people who live with HIV. In many countries, access to direct acting antiviral agents to treat HCV is restricted to individuals with advanced liver disease (METAVIR stage F3 or F4). Our goal was to estimate the long term impact of deferring HCV treatment for men who have sex with men (MSM) who are coinfected with HIV and often have multiple risk factors for liver disease progression. METHODS We developed an individual-based model of liver disease progression in HIV/HCV coinfected men who have sex with men. We estimated liver-related morbidity and mortality as well as the median time spent with replicating HCV infection when individuals were treated in liver fibrosis stages F0, F1, F2, F3 or F4 on the METAVIR scale. RESULTS The percentage of individuals who died of liver-related complications was 2% if treatment was initiated in F0 or F1. It increased to 3% if treatment was deferred until F2, 7% if it was deferred until F3 and 22% if deferred until F4. The median time individuals spent with replicating HCV increased from 5 years if treatment was initiated in F2 to almost 15 years if it was deferred until F4. CONCLUSIONS Deferring HCV therapy until advanced liver fibrosis is established could increase liver-related morbidity and mortality in HIV/HCV coinfected individuals, and substantially prolong the time individuals spend with replicating HCV infection.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

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
04 Faculty of Medicine > Service Sector > Institute of Clinical Pharmacology and Visceral Research (discontinued)

UniBE Contributor:

Zahnd, Cindy; Salazar Vizcaya, Luisa Paola; Dufour, Jean-François; Wandeler, Gilles; Estill, Janne Anton Markus; Bertisch, Barbara; Rauch, Andri and Keiser, Olivia

Subjects:

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

ISSN:

0168-8278

Publisher:

Elsevier

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

09 Jun 2016 16:39

Last Modified:

08 Sep 2017 15:45

Publisher DOI:

10.1016/j.jhep.2016.02.030

PubMed ID:

26921687

Additional Information:

Rauch and Keiser contributed equally to this work.

Uncontrolled Keywords:

Cirrhosis; HIV; Hepatitis C; Hepatocellular carcinoma; Mathematical model

BORIS DOI:

10.7892/boris.79560

URI:

https://boris.unibe.ch/id/eprint/79560

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