Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study

Myroslava Nikolaichuk; Amanda Mocroft; Gilles Wandeler; János Szlavik; Magnus Gottfredsson; Dag Henrik Reikvam; Veronica Svedhem; Hila Elinav; Montserrat Laguno; Kamal Mansinho; Emma Devitt; Nikoloz Chkhartishvili; Georg Behrens; Johannes Bogner; Jean-Paul Viard; Alan Winston; Thomas Benfield; Clifford Leen; Olga Fursa; Jürgen Rockstroh; Lars Peters; EuroSIDA study group

doi:10.1111/hiv.13357

Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study

Myroslava Nikolaichuk, Amanda Mocroft, Gilles Wandeler, János Szlavik, Magnus Gottfredsson, Dag Henrik Reikvam, Veronica Svedhem, Hila Elinav, Montserrat Laguno, Kamal Mansinho, Emma Devitt, Nikoloz Chkhartishvili, Georg Behrens, Johannes Bogner, Jean-Paul Viard, Alan Winston, Thomas Benfield, Clifford Leen, Olga Fursa, Jürgen RockstrohLars Peters^*, EuroSIDA study group

^*Corresponding author for this work

2 Citations (Scopus)

Abstract

OBJECTIVES: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study.

METHODS: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs.

RESULTS: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55).

CONCLUSION: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.

Original language	English
Journal	HIV Medicine
Volume	24
Issue number	2
Pages (from-to)	224-230
Number of pages	7
ISSN	1464-2662
DOIs	https://doi.org/10.1111/hiv.13357
Publication status	Published - Feb 2023

Keywords

co-infection
contraindications
DAA
HCV
HIV

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10.1111/hiv.13357

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Nikolaichuk, M., Mocroft, A., Wandeler, G., Szlavik, J., Gottfredsson, M., Reikvam, D. H., Svedhem, V., Elinav, H., Laguno, M., Mansinho, K., Devitt, E., Chkhartishvili, N., Behrens, G., Bogner, J., Viard, J.-P., Winston, A., Benfield, T., Leen, C., Fursa, O., ... EuroSIDA study group (2023). Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study. HIV Medicine, 24(2), 224-230. https://doi.org/10.1111/hiv.13357

Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study. / Nikolaichuk, Myroslava; Mocroft, Amanda; Wandeler, Gilles et al.
In: HIV Medicine, Vol. 24, No. 2, 02.2023, p. 224-230.

Research output: Contribution to journal › Journal article › Research › peer-review

Nikolaichuk, M, Mocroft, A, Wandeler, G, Szlavik, J, Gottfredsson, M, Reikvam, DH, Svedhem, V, Elinav, H, Laguno, M, Mansinho, K, Devitt, E, Chkhartishvili, N, Behrens, G, Bogner, J, Viard, J-P, Winston, A, Benfield, T, Leen, C, Fursa, O, Rockstroh, J, Peters, L & EuroSIDA study group 2023, 'Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study', HIV Medicine, vol. 24, no. 2, pp. 224-230. https://doi.org/10.1111/hiv.13357

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title = "Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study",

abstract = "OBJECTIVES: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study.METHODS: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs.RESULTS: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55).CONCLUSION: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.",

keywords = "co-infection, contraindications, DAA, HCV, HIV",

author = "Myroslava Nikolaichuk and Amanda Mocroft and Gilles Wandeler and J{\'a}nos Szlavik and Magnus Gottfredsson and Reikvam, {Dag Henrik} and Veronica Svedhem and Hila Elinav and Montserrat Laguno and Kamal Mansinho and Emma Devitt and Nikoloz Chkhartishvili and Georg Behrens and Johannes Bogner and Jean-Paul Viard and Alan Winston and Thomas Benfield and Clifford Leen and Olga Fursa and J{\"u}rgen Rockstroh and Lars Peters and {EuroSIDA study group}",

note = "{\textcopyright} 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.",

year = "2023",

month = feb,

doi = "10.1111/hiv.13357",

language = "English",

volume = "24",

pages = "224--230",

journal = "HIV Medicine",

issn = "1464-2662",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "2",

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TY - JOUR

T1 - Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study

AU - Nikolaichuk, Myroslava

AU - Mocroft, Amanda

AU - Wandeler, Gilles

AU - Szlavik, János

AU - Gottfredsson, Magnus

AU - Reikvam, Dag Henrik

AU - Svedhem, Veronica

AU - Elinav, Hila

AU - Laguno, Montserrat

AU - Mansinho, Kamal

AU - Devitt, Emma

AU - Chkhartishvili, Nikoloz

AU - Behrens, Georg

AU - Bogner, Johannes

AU - Viard, Jean-Paul

AU - Winston, Alan

AU - Benfield, Thomas

AU - Leen, Clifford

AU - Fursa, Olga

AU - Rockstroh, Jürgen

AU - Peters, Lars

AU - EuroSIDA study group

PY - 2023/2

Y1 - 2023/2

N2 - OBJECTIVES: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study.METHODS: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs.RESULTS: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55).CONCLUSION: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.

AB - OBJECTIVES: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study.METHODS: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications ('red shading' in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs.RESULTS: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3-8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40-7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08-0.65) for 2015-2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55).CONCLUSION: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.

KW - co-infection

KW - contraindications

KW - DAA

KW - HCV

KW - HIV

UR - http://www.scopus.com/inward/record.url?scp=85135561991&partnerID=8YFLogxK

U2 - 10.1111/hiv.13357

DO - 10.1111/hiv.13357

M3 - Journal article

C2 - 35934954

SN - 1464-2662

VL - 24

SP - 224

EP - 230

JO - HIV Medicine

JF - HIV Medicine

IS - 2

ER -

Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals-Results from the EuroSIDA study

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