Unsuccessful Direct Acting Antiviral Hepatitis C Treatment Among People With HIV: Findings From an International Cohort.

Autor: Harney BL; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia., Sacks-Davis R; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; School of Population and Global Health, University of Melbourne, Melbourne, Australia., van Santen DK; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands., Stewart AC; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Matthews GV; The Kirby Institute UNSW, Sydney, Australia.; St Vincent's Hospital, Sydney, Australia., Carson JM; The Kirby Institute UNSW, Sydney, Australia., Klein MB; Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Canada., Lacombe K; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.; Service de Maladies Infectieuses, Hôpital Saint-Antoine APHP, Paris, France., Wittkop L; CHU Bordeaux, Service d'information médicale, Bordeaux, France.; University of Bordeaux, INSERM, Bordeaux Population Health Research Centre U1219, CIC-EC, Bordeaux, France.; INRIA SISTM Team, Talence, France., Salmon D; Université Paris Descartes, Service Maladies Infectieuses et Tropicales, AP-HP, Hôpital Cochin, Paris, France., Leleux O; University of Bordeaux, INSERM, Bordeaux Population Health Research Centre U1219, CIC-EC, Bordeaux, France., Merchadou L; University of Bordeaux, INSERM, Bordeaux Population Health Research Centre U1219, CIC-EC, Bordeaux, France., van der Valk M; Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.; Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.; Stichting HIV Monitoring, Amsterdam, The Netherlands., Smit C; Stichting HIV Monitoring, Amsterdam, The Netherlands., Prins M; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.; Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.; Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands., Boyd A; Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.; Stichting HIV Monitoring, Amsterdam, The Netherlands., Berenguer J; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Infectious Diseases, Hospital General Universitario Gregorio Marañón (IsSGM), Madrid, Spain.; Instituto de Salud Carlos III, Madrid, Spain., Jarrin I; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.; Infectious Diseases, Hospital General Universitario Gregorio Marañón (IsSGM), Madrid, Spain.; Instituto de Salud Carlos III, Madrid, Spain., Rauch A; Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Hellard ME; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia.; Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia., Doyle JS; Disease Elimination Program, Burnet Institute, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2025 Jan; Vol. 45 (1), pp. 1-13.
DOI: 10.1111/liv.16203
Abstrakt: Background: Historically, hepatitis C virus (HCV) was difficult to treat among people with HIV. However, treatment with direct-acting antivirals (DAAs) results in 90%-95% of people being cured. There is a need to understand why a proportion of people are not cured. We aimed to examine characteristics that may indicate an increased probability of unsuccessful DAA HCV treatment.
Methods: Data were from the International Collaboration on Hepatitis C Elimination in HIV Cohorts. People who commenced DAA HCV treatment between 2014 and 2019 were included. Unsuccessful treatment was defined as a positive HCV RNA test at a person's first RNA test at least 4 weeks (SVR4+) following the end of treatment. Multivariable mixed-effects logistic regression was used to examine characteristics associated with unsuccessful treatment.
Results: Of 4468 people who commenced DAA treatment, 4098 (91.7%) had an SVR test 4+ weeks following the end of treatment, 207 (5%) of whom were unsuccessfully treated. Compared to a CD4+ cell count > 500 cells/mm 3 , cell counts < 200 (aOR 1.81, 95%CI 1.00-3.29) and between 200 and 349 (aOR 1.95, 95%CI 1.30-2.93) were associated with increased odds of unsuccessful treatment. Among 1921 people with data on injection drug use in the 12 months prior to treatment, there was some evidence that recent injection drug use was associated with increased odds of unsuccessful treatment; however, this was not statistically significant (aOR 1.67, 95%CI 0.99-2.82).
Conclusions: The overwhelming majority of people were successfully treated for HCV. Overall, 5% of those with an SVR4+ test were unsuccessfully treated; this was more likely among people with evidence of immunodeficiency and those who reported recently injecting drugs.
(© 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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