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

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  • S Amele
  • L Peters
  • M Sluzhynska
  • A Yakovlev
  • A Scherrer
  • P Domingo
  • J Gerstoft
  • J P Viard
  • M Gisinger
  • R Flisiak
  • S Bhaghani
  • M Ristola
  • C Leen
  • E Jablonowska
  • G Wandeler
  • H Stellbrink
  • K Falconer
  • A D'Arminio Monforte
  • A Horban
  • J K Rockstroh
  • J D Lundgren
  • A Mocroft
  • EuroSIDA study group
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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.

Original languageEnglish
JournalHIV Medicine
Volume20
Issue number4
Pages (from-to)264-273
Number of pages10
ISSN1464-2662
DOIs
Publication statusPublished - 1 Apr 2019

    Research areas

  • continuum of care, Europe, HIV/HCV coinfection, sustained virological response, treatment

ID: 57370526