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