Hepatitis C Treatment Outcomes in Persons With HIV and Decompensated Cirrhosis Using a Collaborative...

Area of Science:

• Hepatology
• Infectious Diseases
• HIV Medicine

Background:

• Hepatitis C Virus (HCV) infection is a significant concern for individuals with Human Immunodeficiency Virus (HIV) co-infection.
• Liver decompensation in this population presents complex treatment challenges.
• Direct-acting antivirals (DAA) have transformed HCV treatment, but outcomes in HIV co-infected patients with liver disease require further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of direct-acting antivirals (DAA) for treating HCV in patients co-infected with HIV and presenting with liver decompensation.
• To assess the effectiveness of a multidisciplinary, HIV-centered model of care in managing this complex patient group across multiple countries.

Main Methods:

• A cohort of 54 consecutive patients with HIV/HCV co-infection and liver decompensation were treated with DAA.
• Treatment was administered within a multidisciplinary care model integrating specialized services.
• Outcomes including sustained viral response and mortality were monitored.

Main Results:

• A high sustained viral response (SVR) rate of 91% (95% CI, 80.1-95.9) was achieved.
• Treatment demonstrated a favorable safety profile, with only one death occurring during the study period.
• The multidisciplinary HIV-centered approach facilitated successful DAA treatment delivery.

Conclusions:

• Direct-acting antiviral (DAA) therapy is highly effective for achieving sustained viral response in patients with HIV/HCV co-infection and liver decompensation.
• A multidisciplinary, HIV-centered model of care is crucial for optimizing treatment outcomes in this vulnerable population.
• HIV providers can successfully manage HCV treatment in patients with decompensated liver disease using integrated care approaches.