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

Autor: Béguelin, Charles, Suter, Annatina, Bernasconi, Enos, Fehr, Jan, Kovari, Helen, Bucher, Heiner C, Stoeckle, Marcel, Cavassini, Mathias, Rougemont, Mathieu, Schmid, Patrick, Wandeler, Gilles, Rauch, Andri, Swiss HIV Cohort Study
Přispěvatelé: Swiss HIV Cohort Study, Aubert, V., Battegay, M., Böni, J., Braun, D.L., Calmy, A., Ciuffi, A., Dollenmaier, G., Egger, M., Elzi, L., Fellay, J., Furrer, H., Fux, C.A., Günthard, H.F., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R.D., Ledergerber, B., Martinetti, G., Tejada, B., Marzolini, C., Metzner, K.J., Müller, N., Nicca, D., Pantaleo, G., Paioni, P., Rudin, C., Scherrer, A.U., Speck, R., Stöckle, M., Tarr, P., Trkola, A., Vernazza, P., Weber, R., Yerly, S., University of Zurich, Béguelin, Charles
Rok vydání: 2017
Předmět:
Adult
Liver Cirrhosis
Male
medicine.medical_specialty
Sustained Virologic Response
Hepatitis C virus
Liver fibrosis
Human immunodeficiency virus (HIV)
610 Medicine & health
HIV Infections
Hepacivirus
medicine.disease_cause
Antiviral Agents
10234 Clinic for Infectious Diseases
03 medical and health sciences
Liver disease
0302 clinical medicine
Fibrosis
Internal medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
ddc:616
Hepatology
Coinfection
business.industry
Incidence (epidemiology)
virus diseases
HIV
10060 Epidemiology
Biostatistics and Prevention Institute (EBPI)
Hepatitis C
Chronic
Middle Aged
medicine.disease
Institutional repository
10036 Medical Clinic
Antiviral Agents/therapeutic use
Coinfection/drug therapy
Drug Therapy
Combination
Female
HIV/genetics
HIV Infections/complications
HIV Infections/drug therapy
Hepatitis C
Chronic/complications
Hepatitis C
Chronic/drug therapy
Liver Cirrhosis/epidemiology
Liver Cirrhosis/virology
Switzerland/epidemiology
DAA
HCV treatment
fibrosis
long-term trends
uptake and efficacy
Immunology
2721 Hepatology
030211 gastroenterology & hepatology
business
Switzerland
Cohort study
Zdroj: Liver international, vol. 38, no. 3, pp. 424-431
Liver International, Vol. 38, No 3 (2018) pp. 424-431
ISSN: 1478-3223
DOI: 10.1111/liv.13528
Popis: BACKGROUND & AIMS Hepatitis C virus (HCV) therapies with interferon-free second-generation direct-acting antiviral agents (DAAs) are highly effective and well tolerated. They have the potential to increase treatment eligibility and efficacy in HIV-infected patients. We assessed the impact of DAAs on treatment uptake, efficacy as well as its impact on the burden of liver disease in the Swiss HIV Cohort Study (SHCS). METHODS We describe clinical and virological characteristics of patients treated with second generation DAAs. We compared treatment incidence, sustained virological response (SVR)12 and liver fibrosis stages between three time periods: period 1, 01/2009-08/2011 (prior to the availability of DAAs); period 2, 09/2011-03/2014 (first generation DAAs); period 3, 04/2014-12/2015 (second generation DAAs). RESULTS At the beginning of the third period, 876 SHCS participants had a chronic HCV infection of whom 180 (20%) started treatment with a second generation DAA. Three- quarters of them had advanced liver fibrosis (Metavir≥3) of whom 80% were cirrhotics. SVR12 was achieved in 173/180 (96%) patients, 3 patients died and 4 experienced a virological failure. Over the three time periods, treatment uptake (4.5/100py, 5.7/100py, 22.4/100py) and efficacy (54%, 70%, 96% SVR12) continuously increased. The number of cirrhotic patients with replicating HCV infection in the SHCS declined from 25% at the beginning to 12% at the end of the last period. CONCLUSIONS After the introduction of second generation DAAs we observed an increase in treatment uptake and efficacy which resulted in a significant reduction in the number of cirrhotic patients with replicating HCV infection in the SHCS. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
Externí odkaz: