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1. Prevalence and Outcomes for Heavily Treatment-Experienced Individuals Living With Human Immunodeficiency Virus in a European Cohort

Author

Pelchen-Matthews, A., Borges, A. H., Reekie, J., Rasmussen, L. D., Wiese, L., Weber, J., Pradier, C., Degen, O., Paredes, R., Tau, L., Flamholc, L., Gottfredsson, M., Kowalska, J. D., Jablonowska, E., Mozer-Lisewska, I., Radoi, R., Vasylyev, M., Kuznetsova, A., Begovac, J., Svedhem, V., Clark, A., Cozzi-Lepri, A., Harxhi, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Machala, L., Jilich, D., Sedlacek, D., Kronborg, G., Benfield, T., Gerstoft, J., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, J., Aho, I., Viard, J. -P., Girard, P. -M., Fontas, E., Duvivier, C., Rockstroh, J., Behrens, G., Stellbrink, H. J., Stephan, C., Goethe, J. W., Bogner, J., Fatkenheuer, G., Chkhartishvili, N., Sambatakou, H., Adamis, G., Paissios, N., Szlavik, J., Kelly, C., Turner, D., Burke, M., Shahar, E., Hassoun, G., Elinav, H., Haouzi, M., Elbirt, D., D'Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Dragas, S., Stevanovic, M., Reiss, P., Trajanovska, J., Reikvam, D. H., Maeland, A., Bruun, J., Knysz, B., Gasiorowski, J., Inglot, M., Bakowska, E., Flisiak, R., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Beniowski, M., Mularska, E., Kamerys, J., Wojcik, K., Rozplochowski, B., Zagalo, A., Mansinho, K., Maltez, F., Oprea, C., Yakovlev, A., Trofimora, T., Khromova, I., Kuzovatova, E., Borodulina, E., Vdoushkina, E., Ranin, J., Tomazic, J., Miro, J. M., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Callau, P., Rojas, J., Inciarta, A., Moreno, S., del Campo, S., Clotet, B., Jou, A., Puig, J., Llibre, J. M., Santos, J. R., Domingo, P., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Falconer, K., Thalme, A., Sonnerborg, A., Treutiger, C. J., Scherrer, A., Weber, R., Cavassini, M., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Mikhalik, J., Sluzhynska, M., Milinkovic, A., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Mocroft, A., Orkin, C., Winston, A., Leen, C., Wandeler, G., Lundgren, J., Guaraldi, G., Kirk, O., Peters, L., Bojesen, A., Raben, D., Hansen, E. V., Kristensen, D., Larsen, J. F., Fischer, A. H., Amele, S., and Roen, A.

Subjects
Adult, Male, antiretroviral treatment, medicine.medical_specialty, Anti-HIV Agents, Human immunodeficiency virus (HIV), non-AIDS-defining clinical conditions, Comorbidity, Rate ratio, medicine.disease_cause, symbols.namesake, heavily treatment experienced, Acquired immunodeficiency syndrome (AIDS), Antiretroviral Therapy, Highly Active, Internal medicine, medicine, Humans, Pharmacology (medical), Prospective Studies, Poisson regression, Prospective cohort study, Acquired Immunodeficiency Syndrome, business.industry, Confounding, HIV resistance, acquired immunodeficiency syndrome, Middle Aged, Viral Load, prevalence, outcomes, heavily, treatment-experienced, individuals, HIV, medicine.disease, Europe, AIDS, Treatment Outcome, Infectious Diseases, Cohort, symbols, Female, business, Viral load
Abstract

Background: Although antiretroviral treatments have improved survival of persons living with HIV, their long-term use may limit available drug options. We estimated the prevalence of heavily treatment-experienced (HTE) status and the potential clinical consequences of becoming HTE. Setting: EuroSIDA, a European multicenter prospective cohort study. Methods: A composite definition for HTE was developed, based on estimates of antiretroviral resistance and prior exposure to specific antiretroviral regimens. Risks of progressing to clinical outcomes were assessed by Poisson regression, comparing every HTE individual with 3 randomly selected controls who never became HTE. Results: Of 15,570 individuals under follow-up in 2010-2016, 1617 (10.4%, 95% CI: 9.9% to 10.9%) were classified as HTE. 1093 individuals became HTE during prospective follow-up (HTE incidence rate 1.76, CI: 1.66 to 1.87 per 100 person-years of follow-up). The number of HTE individuals was highest in West/Central Europe (636/4019 persons, 15.7%) and lowest in East Europe (26/2279 persons, 1.1%). Although most HTE individuals maintained controlled viral loads (

Published
2021
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2. The association between hepatitis B virus infection and nonliver malignancies in persons living with HIV: results from the EuroSIDA study

Author

Mocroft, Amanda, Miro, Jose M., Wandeler, Gilles, Llibre, Josep M., Boyd, Anders, van Bremen, Kathrin, Beniowski, Marek, Mikhalik, Julia, Cavassini, Matthias, Maltez, Fernando, Duvivier, Claudine, Uberti Foppa, Caterina, Knysz, Brygida, Bakowska, Elzbieta, Kuzovatova, Elena, Domingo, Pere, Zagalo, Alexandra, Viard, Jean Paul, Degen, Olaf, Milinkovic, Ana, Benfield, Thomas, Peters, Lars, Harxhi, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Sedlacek, D., Kronborg, G., Gerstoft, J., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, J., Aho, I., Lacombe, K., Pradier, C., Fontas, E., Rockstroh, J., Behrens, G., Hoffmann, C., Stellbrink, H. J., Stefan, C., Bogner, J., Fätkenheuer, G., Chkhartishvili, N., Sambatakou, H., Adamis, G., Paissios, N., Szlávik, J., Gottfredsson, M., Devitt, E., Tau, L., Turner, D., Burke, M., Shahar, E., Wattad, L. M., Elinav, H., Haouzi, M., Elbirt, D., D’Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Dragas, S., Stevanovic, M., vd Valk, M., Trajanovska, J., Reikvam, D. H., Maeland, A., Bruun, J., Szetela, B., Inglot, M., Flisiak, R., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Mularska, E., Jablonowska, E., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Rozplochowski, B., Mansinho, K., Radoi, R., Oprea, C., Gusev, D., Trofimova, T., Khromova, I., Borodulina, E., Ranin, J., Tomazic, J., Miró, J. M., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Callau, P., Rojas, J., Inciarta, A., Moreno, S., del Campo, S., Clotet, B., Jou, A., Paredes, R., Puig, J., Santos, J. R., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Svedhem, V., Thalme, A., Sönnerborg, A., Brännström, J., Flamholc, L., Kusejko, K., Braun, D., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Sluzhynska, M., Johnson, M. A., Simons, E., Edwards, S., Phillips, A., Orkin, C., Winston, A., Clarke, A., Leen, C., Lundgren, J., Rasmussen, L. D., Kowalska, J. D., Guaraldi, G., Larsen, J. F., Bojesen, A., Neesgaard, B., Jaschinski, N., Fursa, O., Sather, M., Raben, D., Hansen, E. V., Kristensen, D., Fischer, A. H., Jensen, S. K., Elsing, T. W., Reekie, J., Cozzi-Lepri, A., Amele, S., Pelchen-Matthews, A., Roen, A., Tusch, E. S., Bannister, W., Mocroft, A., Miro, J. M., Wandeler, G., Llibre, J. M., Boyd, A., van Bremen, K., Beniowski, M., Mikhalik, J., Cavassini, M., Maltez, F., Duvivier, C., Uberti Foppa, C., Knysz, B., Bakowska, E., Kuzovatova, E., Domingo, P., Zagalo, A., Viard, J. -P., Degen, O., Milinkovic, A., Benfield, T., Peters, L., Harxhi, A., Losso, M., Kundro, M., Schmied, B., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Paduto, D., Clumeck, N., De Wit, S., Delforge, M., Florence, E., Vandekerckhove, L., Hadziosmanovic, V., Begovac, J., Machala, L., Sedlacek, D., Kronborg, G., Gerstoft, J., Katzenstein, T., Pedersen, C., Johansen, I. S., Ostergaard, L., Wiese, L., Moller, N. F., Nielsen, L. N., Zilmer, K., Smidt, J., Aho, I., Lacombe, K., Pradier, C., Fontas, E., Rockstroh, J., Behrens, G., Hoffmann, C., Stellbrink, H. J., Stefan, C., Bogner, J., Fatkenheuer, G., Chkhartishvili, N., Sambatakou, H., Adamis, G., Paissios, N., Szlavik, J., Gottfredsson, M., Devitt, E., Tau, L., Turner, D., Burke, M., Shahar, E., Wattad, L. M., Elinav, H., Haouzi, M., Elbirt, D., D'Arminio Monforte, A., Esposito, R., Mazeu, I., Mussini, C., Mazzotta, F., Gabbuti, A., Lazzarin, A., Castagna, A., Gianotti, N., Galli, M., Ridolfo, A., Uzdaviniene, V., Matulionyte, R., Staub, T., Hemmer, R., Dragas, S., Stevanovic, M., vd Valk, M., Trajanovska, J., Reikvam, D. H., Maeland, A., Bruun, J., Szetela, B., Inglot, M., Flisiak, R., Grzeszczuk, A., Parczewski, M., Maciejewska, K., Aksak-Was, B., Mularska, E., Jablonowska, E., Kamerys, J., Wojcik, K., Mozer-Lisewska, I., Rozplochowski, B., Mansinho, K., Radoi, R., Oprea, C., Gusev, D., Trofimova, T., Khromova, I., Borodulina, E., Ranin, J., Tomazic, J., Laguno, M., Martinez, E., Garcia, F., Blanco, J. L., Martinez-Rebollar, M., Mallolas, J., Callau, P., Rojas, J., Inciarta, A., Moreno, S., del Campo, S., Clotet, B., Jou, A., Paredes, R., Puig, J., Santos, J. R., Gutierrez, M., Mateo, G., Sambeat, M. A., Laporte, J. M., Svedhem, V., Thalme, A., Sonnerborg, A., Brannstrom, J., Flamholc, L., Kusejko, K., Braun, D., Calmy, A., Furrer, H., Battegay, M., Schmid, P., Kuznetsova, A., Sluzhynska, M., Johnson, A. M., Simons, E., Edwards, S., Phillips, A., Johnson, M. A., Orkin, C., Winston, A., Clarke, A., Leen, C., Lundgren, J., Rasmussen, L. D., Kowalska, J. D., Guaraldi, G., Larsen, J. F., Bojesen, A., Neesgaard, B., Jaschinski, N., Fursa, O., Sather, M., Raben, D., Hansen, E. V., Kristensen, D., Fischer, A. H., Jensen, S. K., Elsing, T. W., Reekie, J., Cozzi-Lepri, A., Amele, S., Pelchen-Matthews, A., Roen, A., Tusch, E. S., Bannister, W., and Infectious diseases

Subjects
Hepatitis B virus, Hepatitis B Surface Antigens, Health Policy, virus diseases, HIV Infections, Hepatitis B, digestive system diseases, HBV DNA, hepatitis B, nonliver cancer, Infectious Diseases, Hepatitis B, Chronic, Neoplasms, DNA, Viral, Humans, Pharmacology (medical), 610 Medicine & health
Abstract

Objectives: The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non-liver malignancies in people living with HIV (PLWH). Methods: All persons aged ≥18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results: Of 17485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151766 person-years of follow-up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR)8.42/1000 PYFU; 95% confidence interval (CI) 7.94–8.90/1000 PYFU] and 99 in those HBV positive (IR10.54/1000 PYFU; 95% CI8.47–12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV-positive versus HBV-negative individuals [adjusted incidence rate ratio (aIRR)1.23; 95% CI 1.00–1.51]. Compared to HBV-negative individuals, HBsAg-positive/HBV-DNA-positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00–1.89) and NHL (aIRR 2.57; 95% CI 1.16–5.68). There was no significant association between HBV and lung or anal cancer. Conclusions: We found increased rates of nonliver malignancies in HBsAg-positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV-positive subjects with chronic HBV infection.

Published
2021
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3. Uptake and effectiveness of two-drug compared with three-drug antiretroviral regimens among HIV-positive individuals in Europe

Author

Neesgaard, B, Pelchen-Matthews, A, Ryom, L, Florence, E, Peters, L, Roen, A, Svedhem, V, Clarke, A, Benfield, T, Mitsura, V, Moreno, S, Beniowski, M, Begovac, J, Matulionyte, R, Trofimova, T, Elbirt, D, Kundro, M, Vullo, V, Behrens, G, Staub, T, Ragone, L, Vannappagari, V, Lundgren, J, Mocroft, A, Schmied, B, Zangerle, R, Vassilenko, A, Paduto, D, Clumeck, N, De Wit, S, Delforge, M, Vandekerckhove, L, Hadziosmanovic, V, Machala, L, Jilich, D, Sedlacek, D, Kronborg, G, Gerstoft, J, Katzenstein, T, Pedersen, C, Johansen, IS, Ostergaard, L, Wiese, L, Moller, NF, Nielsen, LN, Zilmer, K, Smidt, J, Ristola, M, Viard, JP, Girard, PM, Fontas, E, Duvivier, C, Degen, O, Stellbrink, HJ, Stefan, C, Goethe, JW, Bogner, J, Fatkenheuer, G, Sambatakou, H, Adamis, G, Paissios, N, Szlavik, J, Gottfredsson, M, Mulcahy, F, Yust, I, Turner, D, Burke, M, Shahar, E, Hassoun, G, Elinav, H, Haouzi, M, Sthoeger, ZM, Monforte, AD, Esposito, R, Mazeu, I, Mussini, C, Mazzotta, F, Gabbuti, A, Lichtner, M, Zaccarelli, M, Antinori, A, Acinapura, R, Plazzi, M, Lazzarin, A, Castagna, A, Gianotti, N, Galli, M, Ridolfo, A, Rozentale, B, Uzdaviniene, V, Hemmer, R, Reiss, P, Reikvam, DH, Maeland, A, Bruun, J, Knysz, B, Gasiorowski, J, Inglot, M, Bakowska, E, Flisiak, R, Grzeszczuk, A, Parczewski, M, Maciejewska, K, Aksak-Was, B, Mularska, E, Smiatacz, T, Gensing, M, Jablonowska, E, Kamerys, J, Wojcik, K, Mozer-Lisewska, I, Rozplochowski, B, Caldeira, L, Mansinho, K, Maltez, F, Radoi, R, Panteleev, A, Panteleev, O, Yakovlev, A, Trofimora, T, Khromova, I, Kuzovatova, E, Borodulina, E, Vdoushkina, E, Miro, JM, Mallolas, J, Martinez, E, Garcia, F, Blanco, JL, Laguno, M, Martinez-Rebollar, M, del Campo, S, Clotet, B, Jou, A, Puig, J, Llibre, JM, Santos, JR, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, MA, Laporte, JM, Falconer, K, Thalme, A, Sonnerborg, A, Treutiger, CJ, Flamholc, L, Scherrer, A, Weber, R, Cavassini, M, Calmy, A, Furrer, H, Battegay, M, Schmid, P, Kuznetsova, A, Kyselyova, G, Sluzhynska, M, Gazzard, B, Johnson, AM, Simons, E, Edwards, S, Johnson, MA, Orkin, C, Weber, J, Scullard, G, Leen, C, Phillips, A, Cozzi-Lepri, A, Shepherd, L, Amele, S, Karpov, I, Losso, M, Rockstroh, J, Aho, I, Rasmussen, LD, Wandeler, G, Pradier, C, Chkhartishvili, N, Oprea, C, Kowalska, JD, Guaraldi, G, and Paredes, R

Subjects
two-drug regimens, nucleot(s)ide reverse transcriptase inhibitor-sparing regimens, simplification, HIV, dual therapy, combination antiretroviral treatment
Abstract

Objective: To assess the use of two-drug antiretroviral regimens (2DR) and virologic and immunologic outcomes compared with three-drug regimens (3DR) in the EuroSIDA cohort. Design: Multicentre, prospective cohort study. Methods: Logistic regression was used to analyse the uptake and outcomes among HIV-positive individuals who started or switched to a 2DR compared with those on a 3DR. Virologic outcomes were assessed on-treatment as the proportion of individuals with controlled viral load (

Published
2019

4. Establishing a hepatitis C continuum of care among HIV/hepatitis C virus-coinfected individuals in EuroSIDA

Author

Viard, JP, Gisinger, M, Bhaghani, S, Stellbrink, H, Horban, A, Rockstroh, JK, Lundgren, JD, Kundro, M, Mejia, JMR, Schmied, B, Zangerle, R, Vassilenko, A, Mitsura, VM, Paduto, D, Clumeck, N, De Wit, S, Delforge, M, Florence, E, Vandekerckhove, L, Hadziosmanovic, V, Machala, L, Jilich, D, Sedlacek, D, Kronborg, G, Benfield, T, Gerstoft, J, Katzenstein, T, Pedersen, C, Johansen, IS, Ostergaard, L, Wiese, L, Moller, NF, Nielsen, LN, Zilmer, K, Smidt, J, Ristola, M, Girard, PM, Fontas, E, Duvivier, C, Behrens, G, Degen, O, Stellbrink, HJ, Stefan, C, Bogner, J, Fatkenheuer, G, Gargalianos, P, Xylomenos, G, Armenis, K, Sambatakou, H, Szlavik, J, Gottfredsson, M, Mulcahy, F, Yust, I, Turner, D, Burke, M, Shahar, E, Hassoun, G, Elinav, H, Haouzi, M, Elbirt, D, Sthoeger, ZM, Monforte, AD, Esposito, R, Mazeu, I, Mussini, C, Mazzotta, F, Gabbuti, A, Vullo, V, Lichtner, M, Zaccarelli, M, Antinori, A, Acinapura, R, Plazzi, M, Lazzarin, A, Castagna, A, Gianotti, N, Galli, M, Ridolfo, A, Rozentale, B, Uzdaviniene, V, Staub, T, Hemmer, R, Reiss, P, Reikvam, DH, Maeland, A, Bruun, J, Knysz, B, Gasiorowski, J, Inglot, M, Bakowska, E, Flisiak, R, Grzeszczuk, A, Parczewski, M, Maciejewska, K, Aksak-Was, B, Beniowski, M, Mularska, E, Smiatacz, T, Gensing, M, Jablonowska, E, Kamerys, J, Wojcik, K, Mozer-Lisewska, I, Caldeira, L, Mansinho, K, Maltez, F, Radoi, R, Panteleev, A, Panteleev, O, Yakovlev, A, Trofimora, T, Khromova, I, Kuzovatova, E, Borodulina, E, Vdoushkina, E, Jevtovic, D, Tomazic, J, Miro, JM, Laguno, M, Martinez, E, Garcia, F, Blanco, JL, Martinez-Rebollar, M, Mallolas, J, Moreno, S, Rodriguez, JM, Clotet, B, Jou, A, Tural, C, Puig, J, Bravo, I, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, MA, Laporte, JM, Falconer, K, Thalme, A, Sonnerborg, A, Treutiger, CJ, Flamholc, L, Scherrer, A, Weber, R, Cavassini, M, Calmy, A, Furrer, H, Battegay, M, Schmid, P, Kuznetsova, A, Kyselyova, G, Sluzhynska, M, Gazzard, B, Johnson, AM, Simons, E, Edwards, S, Johnson, MA, Orkin, C, Weber, J, Scullard, G, Clarke, A, Leen, C, Karpov, I, Losso, M, Lundgren, J, Aho, I, Rasmussen, LD, Svedhem, V, Wandeler, G, Pradier, C, Chkhartishvili, N, Matulionyte, R, Oprea, C, Kowalska, JD, Begovac, J, Miro, J, Guaraldi, G, Paredes, R, Rockstroh, J, Kirk, O, Peters, L, Bojesen, A, Raben, D, Kristensen, D, Laut, K, Larsen, JF, Podlekareva, D, Nykjaer, B, Mocroft, A, Phillips, A, Cozzi-Lepri, A, Amele, S, and Elchen-Matthews, AP

Subjects
Europe, treatment, virus diseases, sustained virological response, continuum of care, HIV/HCV coinfection, digestive system diseases
Abstract

Objectives The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. Methods Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment. Results Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P < 0.0001). Conclusions In the proposed HCV continuum of care for HIV/HCV-coinfected individuals, we found major gaps at all stages, with almost 20% of anti-HCV-positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre-DAA era.

Published
2019

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