Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019
Por:
Fanciulli, C, Berenguer, J, Busca, C, Vivancos, MJ, Tellez, MJ, Dominguez, L, Domingo, P, Navarro, J, Santos, J, Iribarren, JA, Morano, L, Artero, A, Moreno, J, Rivero-Roman, A, Santos, I, Giner, L, Arminanzas, C, Montero, M, Manzardo, C, Cifuentes, C, Garcia, C, Galindo, MJ, Ferrero, OL, Sanz, J, de la Fuente, B, Rodriguez, C, Gaspar, G, Perez, L, Losa, JE, Force, L, Veloso, S, Martinez-Alfaro, E, Jarrin, I, De Miguel, M, Garcia, JG
Publicada:
1 ago 2022
Ahead of Print:
1 ene 2022
Resumen:
Objectives We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population.
Filiaciones:
Fanciulli, C:
Hosp Gen Univ Gregorio Maranon IiSGM, Infect Dis & Clin Microbiol, Madrid, Spain
CIBERINFEC, Madrid, Spain
Berenguer, J:
Hosp Gen Univ Gregorio Maranon IiSGM, Infect Dis & Clin Microbiol, Madrid, Spain
CIBERINFEC, Madrid, Spain
Busca, C:
CIBERINFEC, Madrid, Spain
Hosp Univ La Paz IdiPAZ, HIV Unit, Internal Med, Madrid, Spain
Vivancos, MJ:
CIBERINFEC, Madrid, Spain
Hosp Ramon y Cajal Irycis, Infect Dis, Madrid, Spain
Tellez, MJ:
CIBERINFEC, Madrid, Spain
Hosp Clin San Carlos, Infect Dis, Madrid, Spain
Dominguez, L:
CIBERINFEC, Madrid, Spain
Hosp Univ 12 Octubre, HIV Unit, Internal Med, Madrid, Spain
Domingo, P:
Hosp Santa Creu & Sant Pau, Infect Dis, Barcelona, Spain
Navarro, J:
CIBERINFEC, Madrid, Spain
Hosp Univ Vall dHebron, Infect Dis, Barcelona, Spain
Santos, J:
Hosp Clin Univ Virgen Victoria, Infect Dis, Malaga, Spain
Iribarren, JA:
Hosp Donostia, Infect Dis, San Sebastian, Spain
Morano, L:
Hosp Univ Alvaro Cunqueiro, Infect Dis, Vigo, Spain
Artero, A:
Hosp Univ Doctor Peset, Internal Med & Infect Dis, Valencia, Spain
Moreno, J:
Hosp Univ Miguel Servet, Infect Dis, Zaragoza, Spain
Rivero-Roman, A:
CIBERINFEC, Madrid, Spain
Hosp Univ Reina Sofia, Infect Dis, Cordoba, Spain
Santos, I:
CIBERINFEC, Madrid, Spain
Hosp Univ Princesa, Infect Dis, Madrid, Spain
Giner, L:
Hosp Gen Univ Alicante, Infect Dis, Alicante, Spain
Arminanzas, C:
CIBERINFEC, Madrid, Spain
Hosp Univ Marques Valdecilla, Infect Dis, Santander, Spain
Montero, M:
Hosp Univ & Politecn La Fe, Infect Dis, Valencia, Spain
Manzardo, C:
Hosp Arnau Vilanova, Infect Dis, Lleida, Spain
Hosp Santa Maria, Infect Dis, Lleida, Spain
Cifuentes, C:
Hosp Son Llatzer, Infect Dis, Palma De Mallorca, Spain
Garcia, C:
Hosp Univ Virgen Nieves, Infect Dis, Granada, Spain
Galindo, MJ:
Hosp Clin Valencia, Internal Med & Infect Dis, Valencia, Spain
Ferrero, OL:
Hosp Univ Basurto, Infect Dis, Bilbao, Spain
Sanz, J:
Hosp Univ Principe Asturias, Infect Dis, Alcala De Henares, Spain
de la Fuente, B:
Hosp Univ Cabuenes, Infect Dis, Gijon, Spain
Rodriguez, C:
Ctr Sanitario Sandoval, Madrid, Spain
Gaspar, G:
Hosp Univ Getafe, Internal Med & Infect Dis, Getafe, Spain
Perez, L:
Hosp San Pedro, Infect Dis, Logrono, Spain
Losa, JE:
Fdn Hosp Alcorcon, Infect Dis, Alcorcon, Spain
Force, L:
Hosp Mataro, Internal Med & Infect Dis, Mataro, Spain
Veloso, S:
Hosp Univ Joan XXIII, Infect Dis, Tarragona, Spain
Martinez-Alfaro, E:
Complejo Hosp Univ Albacete, Infect Dis, Albacete, Spain
Jarrin, I:
CIBERINFEC, Madrid, Spain
Inst Salud Carlos III, Ctr Nacl Epidemiol, Madrid, Spain
De Miguel, M:
Fdn SEIMC GESIDA, Madrid, Spain
Garcia, JG:
CIBERINFEC, Madrid, Spain
Hosp Univ La Paz IdiPAZ, HIV Unit, Internal Med, Madrid, Spain
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