Lars Jørgen Østergaard

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

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • S Amele, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
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  • L Peters, University of Copenhagen
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  • M Sluzhynska, Lviv Regional HIV/AIDS Prevention and Control CTR, Lviv, Ukraine.
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  • A Yakovlev, Medical Academy Botkin Hospital, St Petersburg, Russia.
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  • A Scherrer, Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland.
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  • P Domingo, Neurology Department, Hospital de Sant Pau, Barcelona, Spain.
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  • J Gerstoft, University of Copenhagen
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  • J P Viard, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Hospital and Paris Descartes University, Paris, France.
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  • M Gisinger, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria
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  • R Flisiak, Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland.
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  • S Bhaghani, Department of Infectious Diseases/HIV Medicine, Royal Free London Foundation Trust, London, UK.
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  • M Ristola, Department of Child Neurology, Children's Hospital, Helsinki University Hospital Helsinki, University of Helsinki, Helsinki, Finland.
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  • C Leen, Breakthrough Research Unit Edinburgh Breast Unit, Western General Hospital, Edinburgh
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  • E Jablonowska, Department of Infectious Diseases and Hepatology, Medical University, Lodz, Poland.
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  • G Wandeler, Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
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  • H Stellbrink, ICH Study Center, Hamburg, Germany.
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  • K Falconer, Unit of Infectious Diseases and Dermatology, Department of Medicine, Karolinska Institutet, and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
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  • A D'Arminio Monforte, Istituto Di Clinica Malattie Infettive e Tropicale, Milan, Italy.
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  • A Horban, Warsaw Medical University & Hospital of Infectious Diseases, Warsaw, Poland.
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  • J K Rockstroh, Universitäts Klinik Bonn, Bonn, Germany.
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  • J D Lundgren, University of Copenhagen
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  • A Mocroft, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
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  • EuroSIDA Study Group

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.

Original languageEnglish
JournalHIV Medicine
Volume20
Issue4
Pages (from-to)264-273
Number of pages10
ISSN1464-2662
DOIs
Publication statusPublished - Apr 2019

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