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Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA

D Grint1, L Peters, C Schwarze-Zander

  • 1University College London, London, UK.

HIV Medicine
|July 23, 2013
PubMed

Insights

Hepatitis C virus (HCV) treatment uptake increased in HIV-coinfected patients, but many indicated for therapy remain untreated. Further efforts are needed to ensure all eligible patients receive timely HCV treatment.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection is a significant concern for patients coinfected with human immunodeficiency virus (HIV).
  • Guidelines recommend HCV therapy for coinfected individuals with advanced liver fibrosis (≥F2).
  • Understanding HCV treatment uptake patterns in this population is crucial for public health initiatives.

Purpose of the Study:

  • To determine the rate of HCV treatment uptake among HIV/HCV-coinfected patients in Europe.
  • To identify factors influencing the initiation of HCV therapy in this cohort.
  • To assess the proportion of patients indicated for treatment who have not yet received it.

Main Methods:

  • Analysis of data from the EuroSIDA cohort, including patients with viraemic HCV infection.
  • Utilized Poisson regression to analyze temporal trends and regional variations in HCV treatment uptake.
  • Examined patient characteristics, including CD4 cell count and liver fibrosis stage, as predictors of treatment initiation.

Main Results:

  • Out of 1984 HIV/HCV-coinfected patients, 25.3% received HCV therapy during a median follow-up of 168 months.
  • HCV treatment incidence increased from 1998 to 2007, then declined slightly by 2009.
  • Higher CD4 cell counts (>350 cells/μL) and advanced liver fibrosis (≥F2) were associated with increased likelihood of HCV treatment initiation.

Conclusions:

  • Despite an overall increase in HCV treatment incidence, a substantial number of HIV/HCV-coinfected patients who meet criteria for therapy remain untreated.
  • A significant proportion of untreated patients had advanced liver fibrosis (≥F2), indicating a gap in care.
  • Further interventions are necessary to improve HCV treatment accessibility and adherence in this vulnerable population.
Abstract

Keywords:
EuroSIDAHIV/HCV coinfectionPEG-interferonribavirintreatment completion

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