Objectives: All HIV/hepatitis C virus (HCV)-coinfected patients with chronic HCV infection and ⥠F2 fibrosis should be considered for HCV therapy. This study aimed to determine the rate of HCV treatment uptake among coinfected patients in Europe. Methods: EuroSIDA patients with viraemic HCV infection were included in the study. Poisson regression was used to identify temporal changes and regional differences in HCV treatment uptake. Results: A total of 1984 patients were included in the study, with a median follow-up time of 168 months [interquartile range (IQR) 121-204 months]. To date, 501 (25.3%) HIV/HCV-coinfected patients have received HCV therapy. Treatment incidence rose from 0.33 [95% confidence interval (CI) 0.16-0.50] per 100 person-years of follow-up (PYFU) in 1998 to 5.93 (95% CI 4.49-7.38) in 2007, falling to 3.78 (95% CI 2.50-5.07) in 2009. After adjustment, CD4 cell count >350cells/μL [incidence rate ratio (IRR) 1.33 (95% CI 1.06-1.67) vs.CD4 count 200-350 cells/μL] and â¥F2 liver fibrosis [IRR 1.60 (95% CI 1.14-2.25; P=0.0065) vs. <F2 fibrosis] were predictors of anti-HCV treatment initiation. However, 22% of patients who remain untreated for HCV, with fibrosis data available, had â¥F2 fibrosis and should have been considered for treatment, while only 36% of treated patients had â¥F2 fibrosis. Conclusions: Although treatment incidence for HCV has increased, there remain a large proportion of patients indicated for treatment who have yet to be treated. © 2013 British HIV Association.
Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA / Grint, D.; Peters, L.; Schwarze zander, C.; Beniowski, M.; Pradier, C.; Battegay, M.; Jevtovic, D.; Soriano, V.; Lundgren, J. D.; Rockstroh, J. K.; Kirk, O.; Mocroft, A; Eurosida In, Eurocoord; Castagna, Antonella. - In: HIV MEDICINE. - ISSN 1464-2662. - 14:10(2013), pp. 614-623. [10.1111/hiv.12068]
Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA
CASTAGNA, ANTONELLA
2013-01-01
Abstract
Objectives: All HIV/hepatitis C virus (HCV)-coinfected patients with chronic HCV infection and ⥠F2 fibrosis should be considered for HCV therapy. This study aimed to determine the rate of HCV treatment uptake among coinfected patients in Europe. Methods: EuroSIDA patients with viraemic HCV infection were included in the study. Poisson regression was used to identify temporal changes and regional differences in HCV treatment uptake. Results: A total of 1984 patients were included in the study, with a median follow-up time of 168 months [interquartile range (IQR) 121-204 months]. To date, 501 (25.3%) HIV/HCV-coinfected patients have received HCV therapy. Treatment incidence rose from 0.33 [95% confidence interval (CI) 0.16-0.50] per 100 person-years of follow-up (PYFU) in 1998 to 5.93 (95% CI 4.49-7.38) in 2007, falling to 3.78 (95% CI 2.50-5.07) in 2009. After adjustment, CD4 cell count >350cells/μL [incidence rate ratio (IRR) 1.33 (95% CI 1.06-1.67) vs.CD4 count 200-350 cells/μL] and â¥F2 liver fibrosis [IRR 1.60 (95% CI 1.14-2.25; P=0.0065) vs.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.