Uptake of hepatitis C virus treatment in HIV/hepatitis C virus-coinfected patients across Europe in the era of direct-Acting antivirals
Por:
Peters L., Laut K., Resnati C., Campo S.D., Leen C., Falconer K., Trofimova T., Paduta D., Gatell J., Rauch A., Lacombe K., Domingo P., Chkhartishvili N., Zangerle R., Matulionyte R., Mitsura V., Benfield T., Zilmer K., Khromova I., Lundgren J., Rockstroh J., Mocroft A.
Publicada:
1 ene 2018
Resumen:
Background and aims: To investigate the uptake of hepatitisCvirus (HCV) therapy among HIV/HCV-coinfectedpatients inthepan-EuropeanEuroSIDAstudybetween2011and2016. 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 4308HCV-RNA patients (1255, 970, 663, 633, 787 fromSouth,West, North, Central East and East Europe, respectively) with 11 863 person-years of follow-up, 1113(25.8%)started anyHCVtherapy.Among patients with at least F3 fibrosis,more than 50% in all regions remained untreated. The incidence (per 1000 person-years of followup, 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 fromCentral East or East, genotype 3, antiretroviral therapy nai ve and those with detectable HIV-RNAwere less likely to start DAA. Older persons, those withHCV-RNAmore than 500 000 IU/ml and those withmore 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. © 2018 Lippincott Williams and Wilkins. All rights reserved.
Filiaciones:
Peters L.:
CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Laut K.:
CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Resnati C.:
Department of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy
Campo S.D.:
Hospital Universitario Ramon y Cajal, Departamento de Gastroenterologia, Madrid, Spain
Leen C.:
Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, United Kingdom
Falconer K.:
Infectious Diseases Department, Karolinska University Hospital, Stockholm, Sweden
Trofimova T.:
Novgorod Centre for AIDS Prevention and Control Velikij, Novgorod, Russian Federation
Paduta D.:
Epidemiology and Healthcare, Gomel Regional Centre for Hygiene, Gomel, Belarus
Gatell J.:
Hospital Clinic Universitari de Barcelona, Barcelona, Spain
Rauch A.:
Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Lacombe K.:
Hospital Saint-Antoine, Paris, France
Domingo P.:
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Chkhartishvili N.:
Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
Zangerle R.:
Medical University of Innsbruck, Department of Dermatology, Venereology and Allergology, Innsbruck, Austria
Matulionyte R.:
Department of Infectious, Chest Diseases, Dermatovenerology and Allergology, Vilnius University, Lithuania
Centre of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
Mitsura V.:
Infectious Diseases Department, Gomel State Medical University, Gomel, Belarus
Benfield T.:
Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark
Zilmer K.:
Centre of Infectious Diseases, West-Tallinn Central Hospital, Tallinn, Estonia
Khromova I.:
Centre for HIV/AIDS & Infectious Diseases, Kaliningrad, Russian Federation
Lundgren J.:
CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Rockstroh J.:
University of Bonn, Department of Medicine I, Bonn, Germany
Mocroft A.:
Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, United Kingdom
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