Late presentation of chronic hepatitis C patients in the era of direct‐acting antivirals—Data from the German Hepatitis C‐Registry.

Keywords: advanced liver disease; HCV; HIV coinfection; late presentation; viral hepatitis EN advanced liver disease HCV HIV coinfection late presentation viral hepatitis 1660 1664 5 10/19/21 20211101 NES 211101 Abbreviations ALT Alanine-aminotransferase APRI Aspartate-aminotransferase-to-platelet-ratio-index ART Antiretroviral therapy BMI Body mass index DAA Direct acting antiviral DHC-R German Hepatitis C-Registry GECCO German Hepatitis C Cohort GT Genotype HBV Hepatitis B virus HCC Hepatocellular carcinoma HCV Hepatitis C virus HIV Human immunodeficiency virus IVDA intravenous drug abuse LP Late presentation for viral hepatitis MSM Men who have sex with men OST Opioid substitution therapy PrEP Pre-Exposure prophylaxis RNA Ribonucleic acid SVR Sustained virological response WHO World Health Organization INTRODUCTION Chronic liver disease due to hepatitis C virus (HCV) infection is a major public health burden with an estimated 71 million people worldwide suffering from replicative HCV infection.1 Even if diagnosed in an early stage of disease, missing linkage to care or reluctance to treat might defer treatment until progression to an advanced stage of liver disease. Has increased rollout of direct acting antiviral therapy decreased the burden of late presentation and advanced liver disease in patients starting hepatitis C virus therapy in Germany? We aimed to investigate the extent of LP since unrestricted access to DAA therapy in Germany for HCV monoinfected and HIV/HCV coinfected patients in the period 2014-2018. Treatment uptake was about 3 times higher in 2015 compared to 2014 (1100 patients vs. 3055 patients), which reflects most likely the effect of the implementation of DAAs for HCV treatment and unrestricted access in Germany. [Extracted from the article]