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

Peters, Lars; Laut, Kristina Grønborg; Resnati, Chiara; Campo, Santos del; Leen, Clifford; Falconer, Karolin; Trofimova, Tatiana; Paduta, Dzmitry; Gatell, José M.; Rauch, Andri; Lacombe, Karine; Domingo, Peré; Chkhartishvili, Nikoloz; Zangerle, Robert; Matulionytė, Raimonda; Mitsura, V. M.; Benfield, Thomas; Zilmer, Kai; Khromova, Irina; Lundgren, Jens D; Rockstroh, Jürgen K.; Mocroft, Amanda

doi:10.1097/qad.0000000000001928

Cited by 28 publications

(33 citation statements)

References 18 publications

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“…In this period, we noticed a decrease in treatment uptake across all other genotypes (Figure ), highlighting the fact that physicians postponed treatment awaiting for more efficient and more tolerable treatments for non‐1 genotype‐infected individuals. In the second‐generation DAA era, we observed an impressive four‐fold increase in treatment uptake, reaching a treatment incidence of 22 per 100 patient‐years, which is close to the 25 per 100 patient‐years found in EuroSIDA …”

Section: Discussionsupporting

confidence: 73%

“…Distribution of liver fibrosis among patients with active HCV infection in the different periods (At the end of period 2 in April 2014, 876 patients had a chronic HCV infection. In December 2015 at the end of Period 3, 692 patients had a chronic HCV infection)increase in treatment uptake, reaching a treatment incidence of 22 per 100 patient-years, which is close to the 25 per 100 patient-years found in EuroSIDA 30. As a consequence of the improvement in treatment tolerability and efficacy, and because of treatment priorities and reimbursement limitations, three-quarters of patients treated in the secondgeneration DAA era had advanced fibrosis.…”

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confidence: 80%

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Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study

Béguelin

Suter

Bernasconi

et al. 2017

Liver International

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Section: Discussionsupporting

confidence: 73%

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confidence: 80%

Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study

Béguelin

Suter

Bernasconi

et al. 2017

Liver International

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“…Only 56 (4.7%) of the 1195 individuals with a follow‐up HCV RNA test after completing treatment received IFN‐free treatment. Nonetheless, we have already seen a rapid increase in DAA uptake in 2014 and 2015 for all EuroSIDA regions except Eastern Europe . As DAAs are highly effective for all genotypes , we expect to see SVR rates improving in the DAA era.…”

Section: Discussionmentioning

confidence: 95%

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

Amele

Peters

Sluzhynska³

et al. 2019

HIV Medicine

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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.

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“…Uptake of HCV treatment is low in the entire WHO European region, with only 5% of those diagnosed receiving treatment (3). Coverage declines as we go from the West to the East as it was demonstrated in recent publications, including the EuroSIDA report that showed twice as lower uptake of DAA based treatment in CEE countries compared to Western and Northern Europe among HIV/HCV co-infected persons (11,12). High price of new generation DAAs results in restricted prescriptions not only in middle-income countries, but also in high-income settings.…”

Section: Discussionmentioning

confidence: 96%

State of viral hepatitis care in 16 countries of Central and Eastern European Region

Chkhartishvili

Holban

Babić

et al. 2019

Cent Eur J Public Health

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Objectives: Survey was conducted to assess state of viral hepatitis care in Central and Eastern Europe (CEE). Methods: Representatives of 16 CEE countries completed on-line survey in April-May 2017 that collected information on basic epidemiology and availability of key services for HCV and HBV infections. Sources of information provided ranged from national surveillance data to expert opinion. Results: The burden of viral hepatitis varied between countries, ranging from 6,500 to 2 million for HCV and from 10,000 to 3 million for HBV. Access to routine HCV RNA testing and genotyping was reported by 11 and 9 countries, respectively. HCV resistance testing was available in 7 countries. Direct acting antivirals (DAAs) were available in 13 countries, most frequently Sofosbuvir and Ledipasvir/Sofosbuvir (12 countries apiece) and Ombitasvir/Paritaprevir/Dasabuvir (9 countries). HBV DNA testing and HBV genotyping were routinely available in 10 and 7 countries, respectively. Eleven countries reported available treatment with Tenofovir. Conclusions: There are gaps in viral hepatitis care in CEE. Despite the availability of registered modern drugs for HCV and HBV, the access to treatment is limited. Ensuring quality health care is essential to reduce the epidemic and achieve the WHO's goal of eliminating viral hepatitis as a major public health challenge.

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

Abstract: 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.

Cited by 28 publications

References 18 publications

Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study

Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study

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

State of viral hepatitis care in 16 countries of Central and Eastern European Region

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