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

on behalf of the EuroSIDA study group, Sarah Amele , L Peters, M Sluzhynska, M,A Yakovlev, A Scherrer, P Domingo, Jan Gerstoft, Jean-Paul Viard, M Gisinger, R Flisiak, S Bhaghani, M. Ristola, Clifford Leen, E Jablonowska, G Wandeler, Hans-jürgen Stellbrink, K Falconer, Antonella d'Arminio Monforte, Andrzej HorbanJuergen K. Rockstroh, J. D Lundgren, Amanda Mocroft

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To establish a methodology for evaluating the hepatitis C continuum of care in HIV/HCV co-infected individuals and to characterise the continuum in Europe on 1/1/2015, prior to widespread access to direct-acting antiviral (DAA) therapy. Methods: Stages included in the continuum were: 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 virologic 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 more than 12 or 24 weeks after stopping treatment. Results: Following stages of the HCV continuum of care were defined: anti-HCV positive (n=5173), HCV-RNA tested (4207/5173; 81.3%), currently HCV-RNA positive (3179/5173; 61.5%), ever HCV-RNA positive (n=3876), initiated HCV treatment (1693/3876; 43.7%), completed HCV treatment (1598/3876; 41.2%), follow-up HCV-RNA test to allow SVR assessment (1195/3876; 30.8%), and cure (629/3876; 16.2%). The proportion that achieved SVR was 52.6% (629/1195). 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 co-infected 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
Early online date8 Feb 2019
DOIs
Publication statusPublished - 8 Feb 2019

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