Lars Peters1, Kamilla Laut1, Chiara Resnati2, Santos Del Campo3, Clifford Leen4, Karolin Falconer5, Tatyana Trofimova6, Dzmitry Paduta7, Jose Gatell8, Andri Rauch9, Karine Lacombe10, Pere Domingo11, Nikoloz Chkhartishvili12, Robert Zangerle13, Raimonda Matulionyte14,15, Viktar Mitsura16, Thomas Benfield17, Kai Zilmer18, Irina Khromova19, Jens Lundgren1, Jürgen Rockstroh20, Amanda Mocroft21. 1. CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 2. Department of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy. 3. Hospital Universitario Ramón y Cajal, Departamento de Gastroenterología, Madrid, Spain. 4. Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK. 5. Infectious Diseases Department, Karolinska University Hospital, Stockholm, Sweden. 6. Novgorod Centre for AIDS Prevention and Control, Velikij, Novgorod, Russia. 7. Epidemiology and Healthcare, Gomel Regional Centre for Hygiene, Gomel, Belarus. 8. Hospital Clinic Universitari de Barcelona, Barcelona, Spain. 9. Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 10. Hospital Saint-Antoine, Paris, France. 11. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 12. Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia. 13. Medical University of Innsbruck, Department of Dermatology, Venereology and Allergology, Innsbruck, Austria. 14. Department of Infectious, Chest Diseases, Dermatovenerology and Allergology, Vilnius University. 15. Centre of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania. 16. Infectious Diseases Department, Gomel State Medical University, Gomel, Belarus. 17. Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark. 18. Centre of Infectious Diseases, West-Tallinn Central Hospital, Tallinn, Estonia. 19. Centre for HIV/AIDS & Infectious Diseases, Kaliningrad, Russia. 20. University of Bonn, Department of Medicine I, Bonn, Germany. 21. Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
Abstract
BACKGROUND AND AIMS: To investigate the uptake of hepatitis C virus (HCV) therapy among HIV/HCV-coinfected patients in the pan-European EuroSIDA study between 2011 and 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 interferon-free direct-acting antiviral (DAA) therapy was calculated. Factors associated with starting interferon-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 11 863 person-years of follow-up, 1113 (25.8%) started any HCV therapy. Among patients with at least F3 fibrosis, more than 50% in all regions remained untreated. The incidence (per 1000 person-years of follow-up, 95% confidence interval) 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, women, 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 more than 500 000 IU/ml and those with more advanced liver fibrosis were more likely to start DAA. CONCLUSION: 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 at least F3 fibrosis remained untreated. Women were less likely to start DAA.
BACKGROUND AND AIMS: To investigate the uptake of hepatitis C virus (HCV) therapy among HIV/HCV-coinfectedpatients in the pan-European EuroSIDA study between 2011 and 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 interferon-free direct-acting antiviral (DAA) therapy was calculated. Factors associated with starting interferon-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 11 863 person-years of follow-up, 1113 (25.8%) started any HCV therapy. Among patients with at least F3 fibrosis, more than 50% in all regions remained untreated. The incidence (per 1000 person-years of follow-up, 95% confidence interval) 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, women, 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 more than 500 000 IU/ml and those with more advanced liver fibrosis were more likely to start DAA. CONCLUSION: Uptake of DAA therapy among HIV/HCV-coinfectedpatients increased considerably in Western Europe between 2014 and 2016, but was modest in Central East and East. In all regions more than 50% with at least F3 fibrosis remained untreated. Women were less likely to start DAA.
Authors: Maria A Corcorran; Natasha Ludwig-Baron; Debbie M Cheng; Dmitry Lioznov; Natalia Gnatienko; Gregory Patts; Kaku So-Armah; Elena Blokhina; Sally Bendiks; Evgeny Krupitsky; Jeffrey H Samet; Judith I Tsui Journal: AIDS Behav Date: 2021-03-17
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