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Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA
Author(s) -
Grint D,
Peters L,
SchwarzeZander C,
Beniowski M,
Pradier C,
Battegay M,
Jevtovic D,
Soriano V,
Lundgren JD,
Rockstroh JK,
Kirk O,
Mocroft A
Publication year - 2013
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12068
Subject(s) - medicine , interquartile range , hepatitis c , gastroenterology , incidence (geometry) , hepatitis c virus , confidence interval , fibrosis , rate ratio , poisson regression , immunology , virus , population , physics , environmental health , optics
Objectives All HIV /hepatitis C virus ( HCV )‐coinfected patients with chronic HCV infection and ≥ F 2 fibrosis should be considered for HCV therapy. This study aimed to determine the rate of HCV treatment uptake among coinfected patients in Europe. Methods EuroSIDA patients with viraemic HCV infection were included in the study. Poisson regression was used to identify temporal changes and regional differences in HCV treatment uptake. Results A total of 1984 patients were included in the study, with a median follow‐up time of 168 months [interquartile range ( IQR ) 121–204 months]. To date, 501 (25.3%) HIV / HCV ‐coinfected patients have received HCV therapy. Treatment incidence rose from 0.33 [95% confidence interval ( CI ) 0.16–0.50] per 100 person‐years of follow‐up ( PYFU ) in 1998 to 5.93 (95% CI 4.49–7.38) in 2007, falling to 3.78 (95% CI 2.50–5.07) in 2009. After adjustment, CD4 cell count > 350 cells/μL [incidence rate ratio ( IRR ) 1.33 (95% CI 1.06–1.67) vs. CD4 count 200−350 cells/μL] and ≥ F 2 liver fibrosis [ IRR 1.60 (95% CI 1.14–2.25; P = 0.0065) vs. < F 2 fibrosis] were predictors of anti‐ HCV treatment initiation. However, 22% of patients who remain untreated for HCV , with fibrosis data available, had ≥ F 2 fibrosis and should have been considered for treatment, while only 36% of treated patients had ≥ F 2 fibrosis. Conclusions Although treatment incidence for HCV has increased, there remain a large proportion of patients indicated for treatment who have yet to be treated.