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
|
Text
HCV_J_Hepatology_2016_accepted_version.pdf - Accepted Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (4MB) | Preview |
|
|
Text
Zahnd JHepatol 2016.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (753kB) | Preview |
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.
Actions (login required)
 |
Edit item |