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Effectiveness and safety of IFN-free DAA HCV therapy in HIV/HCV co-infected persons: Results from a pan-European study

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  • Sarah Amele, Univ Coll London Hosp NHS Fdn Trust, University College London Hospitals NHS Foundation Trust, University of London, University College London, Inst Nucl Med
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  • Lars Peters, University of Copenhagen
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  • Alison Rodger, Univ Coll London Hosp NHS Fdn Trust, University College London Hospitals NHS Foundation Trust, University of London, University College London, Inst Nucl Med
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  • Jens Lundgren, University of Copenhagen
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  • Jϋrgen 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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  • Raimonda Matulionyte, Epilepsy Centre, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania; Clinic of Neurology and Neurosurgery, Medical Faculty, Vilnius University, Vilnius, Lithuania.
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  • Clifford Leen, Western General Hospital
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  • Elzbieta Jabłonowska, Wojewodzki Szpital Specjalistyczny
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  • Lars Østergaard
  • Sanjay Bhagani, Royal Free and University College Medical School, London
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  • Mario Sarcletti, Univ Klin Innsbruck, Medical University of Innsbruck
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  • Amanda Clarke, Royal Sussex County Hospital
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  • Karolin Falconer, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital
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  • Gilles Wandeler, Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and.
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  • Pere Domingo, Hosp Santa Creu & Sant Pau, Hospital of Santa Creu i Sant Pau, Med Dept
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  • Fernando Maltez, Hospital Curry Cabral
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  • Mauro Zaccarelli, Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
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  • Nikoloz Chkhartisvili, AIDS and Clinical Immunology Research Center
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  • Janos Szlavik, Szent Lásló Hospital
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  • Christoph Stephan, JW Goethe University Hospital
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  • Laurent Fonquernie, Hospital Saint-Antoine, Paris, France.
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  • Inka Aho, Department of Child Neurology, Children's Hospital, Helsinki University Hospital Helsinki, University of Helsinki, Helsinki, Finland.
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  • Amanda Mocroft, Univ Coll London Hosp NHS Fdn Trust, University College London Hospitals NHS Foundation Trust, University of London, University College London, Inst Nucl Med

OBJECTIVES: To investigate the effectiveness, safety and reasons for premature discontinuation of direct-acting antivirals (DAAs) in a diverse population of HIV/HCV co-infected individuals in Europe.

METHODS: All HIV/HCV co-infected individuals in the EuroSIDA study that started interferon (IFN) free DAA treatment between 1/6/2014 and 1/3/2018 with ≥12 weeks of follow-up after treatment stop were included in this analysis. Sustained virological response (SVR) was defined as a negative HCV-RNA result ≥12 weeks after stopping treatment (SVR12). Logistic regression was used to explore factors associated with SVR12.

RESULTS: 1042 individuals started IFN-free DAA treatment after 1/6/2014 and were included, 862 (82.2%) had a known response to treatment, 789 (91.5%, 95% CI 89.7-93.4) of which achieved SVR12. There were no differences in SVR12 across regions of Europe (p=0.84). After adjustment, the odds of achieving SVR12 was lower in individuals that received sofosbuvir/simeprevir +/- RBV (aOR 0.21 (95% CI 0.08-0.53) or ombitasvir/paritaprevir/dasabuvir +/- RBV (aOR 0.46 (95% CI 0.22-1.00) compared to sofosbuvir/ledipasvir +/- RBV. 43 (4.6%) individuals had one or more components of their HCV regimen stopped early, most commonly due to toxicity (n=14); of these 14, 11 were treated with ribavirin. Increased bilirubin was the most common grade 3 or 4 laboratory adverse event (n=15.3%) and was related to treatment with atazanavir and ribavirin.

CONCLUSIONS: Our findings from real-world data on HIV/HCV co-infected individuals across Europe show DAA treatment is well tolerated, and that high rates of SVR12 can be achieved in all regions of Europe.

Original languageEnglish
JournalJ A I D S
Volume86
Issue2
Number of pages10
ISSN1525-4135
DOIs
Publication statusPublished - Feb 2021

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