HCV reinfection after HCV therapy among HIV/HCV-coinfected individuals in Europe
Por:
Amele, S, Sandri, AK, Rodger, A, Vandekerckhove, L, Benfield, T, Milinkovic, A, Duvivier, C, Stellbrink, HJ, Sambatakou, H, Chkhartishvili, N, Caldeira, L, Laguno, M, Domingo, P, Wandeler, G, Gisinger, M, Kuzovatova, E, Dragovic, G, Knysz, B, Matulionyte, R, Rockstroh, JK, Lundgren, JD, Mocroft, A, Peters, L
Publicada:
1 jul 2022
Ahead of Print:
1 dic 2021
Resumen:
Objectives Although direct-acting antivirals (DAAs) can clear HCV in nearly all HIV/HCV-coinfected individuals, high rates of reinfection may hamper efforts to eliminate HCV in this population. We investigated reinfection after sustained virological response (SVR) in HIV/HCV-coinfected individuals in Europe. Methods Factors associated with odds of reinfection by 2 years after SVR in EuroSIDA participants with one or more HCV-RNA test and 2 years follow-up were assessed using logistic regression. Results Overall, 1022 individuals were included. The median age was 50 (interquartile range: 43-54 years), and most were male (78%), injection drug users (52%), and received interferon (IFN)-free DAAs (62%). By 24 months, 75 [7.3%, 95% confidence interval (CI): 5.7-8.9%] individuals were reinfected. Among individuals treated prior to 2014, 16.1% were reinfected compared with 4.2% and 8.3%, respectively, among those treated during or after 2014 with IFN-free and IFN-based therapy. After adjustment, individuals who had started treatment during or after 2014 with IFN-free or IFN-based therapy had significantly lower odds of reinfection (adjusted odds ratio = 0.21, 95% CI: 0.11-0.38; 0.43, 95% CI: 0.22-0.83) compared with those who had received therapy before 2014. There were no significant differences in odds of reinfection according to age, gender, European region, HIV transmission risk group or liver fibrosis. Conclusions Among HIV/HCV-coinfected individuals in Europe, 7.3% were reinfected with HCV within 24 months of achieving SVR, with evidence suggesting that this is decreasing over time and with use of newer HCV regimens. Harm reduction to reduce reinfection and surveillance to detect early reinfection with an offer of treatment are essential to eliminate HCV.
Filiaciones:
Amele, S:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat, Inst Global Hlth, London, England
Sandri, AK:
Rigshosp, CHIP, Copenhagen, Denmark
Rodger, A:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat, Inst Global Hlth, London, England
Vandekerckhove, L:
Ghent Univ Hosp, Ghent, Belgium
Benfield, T:
Copenhagen Univ Hosp Amager & Hvidovre, Hvidovre, Denmark
Milinkovic, A:
Chelsea & Westminster Hosp, London, England
Duvivier, C:
Necker Enfants Malad Hosp, AP HP, Infect Dis Dept, Paris, France
Necker Pasteur Ctr Infect Dis & Trop Med, Paris, France
Univ Paris, Paris, France
IHU Imagine, Paris, France
Stellbrink, HJ:
ICH Study Ctr, Hamburg, Germany
Sambatakou, H:
Hippokrateion Hosp, Athens, Greece
Chkhartishvili, N:
Infect Dis AIDS & Clin Immunol Res Ctr, Tbilisi, Georgia
Caldeira, L:
Univ Lisbon, Santa Maria Univ Hosp, Lisbon, Portugal
Laguno, M:
Hosp Clin Barcelona, Infect Dis Serv, Barcelona, Spain
Domingo, P:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Wandeler, G:
Univ Bern, Bern Univ Hosp, Dept Infect Dis, Bern, Switzerland
Gisinger, M:
Med Univ Innsbruck, Innsbruck, Austria
Kuzovatova, E:
Nizhny Novgorod Sci & Res Inst, Nizhnii Novgorod, Russia
Dragovic, G:
Univ Belgrade, Sch Med, Dept Pharmacol Clin Pharmacol & Toxicol, Belgrade, Serbia
Knysz, B:
Wroclaw Med Univ, Wroclaw, Poland
Matulionyte, R:
Vilnius Univ, Fac Med, Dept Infect Dis & Dermatovenerol, Vilnius, Lithuania
Vilnius Univ Hosp Santaros Klin, Vilnius, Lithuania
Rockstroh, JK:
Univ Klin Bonn, Bonn, Germany
Lundgren, JD:
Rigshosp, CHIP, Copenhagen, Denmark
Mocroft, A:
UCL, Ctr Clin Res Epidemiol Modelling & Evaluat, Inst Global Hlth, London, England
Rigshosp, CHIP, Copenhagen, Denmark
Peters, L:
Rigshosp, CHIP, Copenhagen, Denmark
|