S Amele1, L Peters2, M Sluzhynska3, A Yakovlev4, A Scherrer5, P Domingo6, J Gerstoft7, J P Viard8, M Gisinger9, R Flisiak10, S Bhaghani11, M Ristola12, C Leen13, E Jablonowska14, G Wandeler15, H Stellbrink16, K Falconer17, A D'Arminio Monforte18, A Horban19, J K Rockstroh20, J D Lundgren2, A Mocroft1. 1. Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London, London, UK. 2. CHIP, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. 3. Lviv Regional HIV/AIDS Prevention and Control CTR, Lviv, Ukraine. 4. Medical Academy Botkin Hospital, St Petersburg, Russia. 5. University Hospital Zurich, Zurich, Switzerland. 6. Hospital Sant Pau, Barcelona, Spain. 7. Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. 8. Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Hospital and Paris Descartes University, Paris, France. 9. Medical University Innsbruck, Innsbruck, Austria. 10. Department of Infectious Diseases and Hepatology, Medical University, Bialystok, Poland. 11. Department of Infectious Diseases/HIV Medicine, Royal Free London Foundation Trust, London, UK. 12. Helsinki University Hospital, Helsinki, Finland. 13. Western General Hospital, Edinburgh, UK. 14. Department of Infectious Diseases and Hepatology, Medical University, Lodz, Poland. 15. Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland. 16. ICH Study Center, Hamburg, Germany. 17. Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. 18. Istituto Di Clinica Malattie Infettive e Tropicale, Milan, Italy. 19. Warsaw Medical University & Hospital of Infectious Diseases, Warsaw, Poland. 20. Universitäts Klinik Bonn, Bonn, Germany.
Abstract
OBJECTIVES: The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. METHODS: Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment. RESULTS: Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P < 0.0001). CONCLUSIONS: In the proposed HCV continuum of care for HIV/HCV-coinfected individuals, we found major gaps at all stages, with almost 20% of anti-HCV-positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre-DAA era.
OBJECTIVES: The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. METHODS: Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment. RESULTS: Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P < 0.0001). CONCLUSIONS: In the proposed HCV continuum of care for HIV/HCV-coinfected individuals, we found major gaps at all stages, with almost 20% of anti-HCV-positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre-DAA era.
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
Authors: Juan Berenguer; Juan González Garcia; Chiara Fanciulli; Carmen Busca; María J Vivancos; María J Téllez; Lourdes Domínguez; Pere Domingo; Jordi Navarro; Jesús Santos; José A Iribarren; Luis Morano; Arturo Artero; Javier Moreno; Antonio Rivero-Román; Ignacio Santos; Livia Giner; Carlos Armiñanzas; Marta Montero; Christian Manzardo; Carmen Cifuentes; Coral García; María J Galindo; Oscar L Ferrero; José Sanz; Belén de la Fuente; Carmen Rodríguez; Gabriel Gaspar; Laura Pérez; Juan E Losa; Luis Force; Sergio Veloso; Elisa Martínez-Alfaro; Inmaculada Jarrín; Marta De Miguel Journal: HIV Med Date: 2022-01-17 Impact factor: 3.094
Authors: Caroline Schmidbauer; David Chromy; Victor Schmidbauer; David Bauer; Michael Apata; Dung Nguyen; Mattias Mandorfer; Benedikt Simbrunner; Armin Rieger; Florian Mayer; Ralf Schmidt; Heidemarie Holzmann; Michael Trauner; Michael Gschwantler; Thomas Reiberger Journal: Liver Int Date: 2020-03-04 Impact factor: 5.828