Human Immunodeficiency Virus/Hepatits C Virus Coinfection in Spain: Elimination Is Feasible, but the Burden of Residual Cirrhosis Will Be Significant
Por:
Berenguer, J, Jarrin, I, Perez-Latorre, L, Hontanon, V, Vivancos, MJ, Navarro, J, Tellez, MJ, Guardiola, JM, Iribarren, JA, Rivero-Juarez, A, Marquez, M, Artero, A, Morano, L, Santos, I, Moreno, J, Farinas, MC, Galindo, MJ, Hernando, MA, Montero, M, Cifuentes, C, Domingo, P, Sanz, J, Domingez, L, Ferrero, OL, De la Fuente, B, Rodriguez, C, Reus, S, Hernandez-Quero, J, Gaspar, G, Perez-Martinez, L, Garcia, C, Force, L, Veloso, S, Losa, JE, Vilaro, J, Bernal, E, Arponen, S, Orti, AJ, Chocarro, A, Teira, R, Alonso, G, Silvarino, R, Vegas, A, Geijo, P, Bisbe, J, Esteban, H, Gonzalez-Garcia, J
Publicada:
1 ene 2018
Resumen:
Background. We assessed the prevalence of antibodies against hepatitis C virus (HCV-Abs) and active HCV infection in patients infected with human immunodeficiency virus (HIV) in Spain in 2016 and compared the results with those of similar studies performed in 2002, 2009, and 2015.
Methods. The study was performed in 43 centers during October-November 2016. The sample was estimated for an accuracy of 2% and selected by proportional allocation and simple random sampling. During 2016, criteria for therapy based on direct-acting antiviral agents (DAA) were at least significant liver fibrosis, severe extrahepatic manifestations of HCV, and high risk of HCV transmissibility.
Results. The reference population and the sample size were 38 904 and 1588 patients, respectively. The prevalence of HCV-Abs in 2002, 2009, 2015, and 2016 was 60.8%, 50.2%, 37.7%, and 34.6%, respectively (P trend <.001, from 2002 to 2015). The prevalence of active HCV in 2002, 2009, 2015, and 2016 was 54.0%, 34.0%, 22.1%, and 11.7%, respectively (P trend <.001). The anti-HCV treatment uptake in 2002, 2009, 2015, and 2016 was 23.0%, 48.0%, 59.3%, and 74.7%, respectively (P trend <.001). In 2016, HCV-related cirrhosis was present in 7.6% of all HIV-infected individuals, 15.0% of patients with active HCV, and 31.5% of patients who cleared HCV after anti-HCV therapy.
Conclusions. Our findings suggest that with universal access to DAA-based therapy and continued efforts in prevention and screening, it will be possible to eliminate active HCV among HIV-infected individuals in Spain in the short term. However, the burden of HCV-related cirrhosis will continue to be significant among HIV-infected individuals.
Filiaciones:
Berenguer, J:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Jarrin, I:
Inst Salud Carlos III, Madrid, Spain
Perez-Latorre, L:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hontanon, V:
Hosp Univ La Paz, Inst Invest Sanitaria La Paz, Madrid, Spain
Vivancos, MJ:
Hosp Univ Ramon y Cajal, Madrid, Spain
Hosp Clin San Carlos, Madrid, Spain
Navarro, J:
Hosp Valle De Hebron, Barcelona, Spain
Tellez, MJ:
Hosp Clin San Carlos, Madrid, Spain
Guardiola, JM:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Iribarren, JA:
Hosp Univ Donostia, San Sebastian, Spain
Rivero-Juarez, A:
Hosp Univ Reina Sofia, Inst Maimonides Invest Biomed Cordoba, Cordoba, Spain
Marquez, M:
Hosp Virgen de la Victoria, Malaga, Spain
Artero, A:
Hosp Doctor Peset, Valencia, Spain
Morano, L:
Hosp Univ Alvaro Cunqueiro, Vigo, Spain
Santos, I:
Hosp Univ Princesa, Madrid, Spain
Moreno, J:
Hosp Miguel Servet, Zaragoza, Spain
Farinas, MC:
Hosp Univ Marques de Valdecilla, Santander, Spain
Galindo, MJ:
Hosp Clin Valencia, Valencia, Spain
Hernando, MA:
Univ Europea, Inst Invest, Hosp Univ 12 Octubre, Madrid, Spain
Montero, M:
Hosp La Fe, Valencia, Spain
Cifuentes, C:
Hosp Son Llatzer, Palma De Mallorca, Spain
Domingo, P:
Hosp Arnau Vilanova, Lleida, Spain
Sanz, J:
Hosp Univ Principe de Asturias, Alcala De Henares, Spain
Domingez, L:
Hosp Univ 12 Octubre, Inst Invest, Madrid, Spain
Ferrero, OL:
Univ Basurto, Bilbao, Spain
De la Fuente, B:
Hosp Cabuenes, Gijon, Spain
Rodriguez, C:
Ctr Sanitario Sandoval, Madrid, Spain
Reus, S:
Hosp Gen Alicante, Alicante, Spain
Hernandez-Quero, J:
Hosp Clin San Cecilio, Granada, Spain
Gaspar, G:
Hosp Univ Getafe, Getafe, Spain
Perez-Martinez, L:
Hosp la Rioja, Logrono, Spain
Garcia, C:
Hosp Virgen de las Nieves, Granada, Spain
Force, L:
Hosp Mataro, Mataro, Spain
Veloso, S:
Hosp Gen Alicante, Alicante, Spain
Hosp Joan 23, Tarragona, Spain
Losa, JE:
Fdn Hosp Alcorcon, Madrid, Spain
Vilaro, J:
Hosp Univ Vic, Vic, Spain
Bernal, E:
Hosp Reina Sofia, Murcia, Spain
Arponen, S:
Hosp Univ Torrejon, Torrejon De Ardoz, Spain
Orti, AJ:
Hosp Virgen de la Cinta, Tortosa, Spain
Chocarro, A:
Hosp Virgen de la Concha, Zamora, Spain
Teira, R:
Hosp Sierrallana, Torrelavega, Spain
Alonso, G:
Hosp Rafael Mendez, Lorca, Spain
Silvarino, R:
Hosp San Eloy, Baracaldo, Spain
Vegas, A:
Hosp Infanta Elena, Valdemoro, Spain
Geijo, P:
Hosp Virgen de la Luz, Cuenca, Spain
Bisbe, J:
Fundacio Hosp St Jaume, Olot, Spain
Esteban, H:
Fdn SEIMC GESIDA, Madrid, Spain
Gonzalez-Garcia, J:
Hosp Univ La Paz, Inst Invest Sanitaria La Paz, Madrid, Spain
Gold, Green Published
|