Lars Jørgen Østergaard

Uptake of hepatitis C virus treatment in HIV/hepatitis C virus-coinfected patients across Europe in the era of direct-acting antivirals

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

  • Lars Peters, University of Copenhagen
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  • Kamilla Laut, University of Copenhagen
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  • Chiara Resnati, Department of Infectious Diseases, Luigi Sacco University Hospital, Milan, Italy.
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  • Santos Del Campo, Hospital Universitario Ramón y Cajal, Departamento de Gastroenterología, Madrid, Spain.
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  • Clifford Leen, Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK.
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  • Karolin 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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  • Tatyana Trofimova, Novgorod Centre for AIDS Prevention and Control, Velikij, Novgorod, Russia.
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  • Dzmitry Paduta, Epidemiology and Healthcare, Gomel Regional Centre for Hygiene, Gomel, Belarus.
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  • Jose Gatell, Hospital Clinic Universitari de Barcelona, Barcelona, Spain.
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  • Andri Rauch, Department of Infectious Diseases, University Hospital, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland.
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  • Karine Lacombe, Hospital Saint-Antoine, Paris, France.
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  • Pere Domingo, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
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  • Nikoloz Chkhartishvili, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
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  • Robert Zangerle, Medical University of Innsbruck, Department of Dermatology, Venereology and Allergology, Innsbruck, Austria.
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  • Raimonda Matulionyte, Centre of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
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  • Viktar Mitsura, Infectious Diseases Department, Gomel State Medical University, Gomel, Belarus.
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  • Thomas Benfield, University of Copenhagen
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  • Kai Zilmer, Centre of Infectious Diseases, West-Tallinn Central Hospital, Tallinn, Estonia.
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  • Irina Khromova, Centre for HIV/AIDS & Infectious Diseases, Kaliningrad, Russia.
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  • Jens Lundgren, University of Copenhagen
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  • Jürgen Rockstroh, Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn 53127, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn 53127, Germany.
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  • Amanda 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

BACKGROUND AND AIMS: To investigate the uptake of hepatitis C virus (HCV) therapy among HIV/HCV-coinfected patients in the pan-European EuroSIDA study between 2011 and 2016.

METHODS: All HCV-RNA+ patients were included. Baseline was defined as latest of anti-HCV+, January 2011 or enrolment in EuroSIDA. The incidence of starting first interferon-free direct-acting antiviral (DAA) therapy was calculated. Factors associated with starting interferon-free DAA were determined by Poisson regression.

RESULTS: Among 4308 HCV-RNA+ patients (1255, 970, 663, 633, 787 from South, West, North, Central East and East Europe, respectively) with 11 863 person-years of follow-up, 1113 (25.8%) started any HCV therapy. Among patients with at least F3 fibrosis, more than 50% in all regions remained untreated. The incidence (per 1000 person-years of follow-up, 95% confidence interval) of starting DAA increased from 7.8 (5.9-9.8) in 2014 to 135.2 (122.0-148.5) in 2015 and 128.9 (113.5-144.3) in 2016. The increase was highest in North and West and intermediate in South, but remained modest in Central East and Eastern Europe. After adjustment, women, individuals from Central East or East, genotype 3, antiretroviral therapy naïve and those with detectable HIV-RNA were less likely to start DAA. Older persons, those with HCV-RNA more than 500 000 IU/ml and those with more advanced liver fibrosis were more likely to start DAA.

CONCLUSION: Uptake of DAA therapy among HIV/HCV-coinfected patients increased considerably in Western Europe between 2014 and 2016, but was modest in Central East and East. In all regions more than 50% with at least F3 fibrosis remained untreated. Women were less likely to start DAA.

Original languageEnglish
JournalAIDS
Volume32
Issue14
Pages (from-to)1995-2004
Number of pages10
ISSN0269-9370
DOIs
Publication statusPublished - 10 Sep 2018

    Research areas

  • Adult, Antiviral Agents/therapeutic use, Coinfection/drug therapy, Drug Utilization/statistics & numerical data, Europe, Facilities and Services Utilization/statistics & numerical data, Female, HIV Infections/complications, Hepatitis C, Chronic/drug therapy, Humans, Male, Middle Aged, Prospective Studies

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