Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA.
HIV Med
; 14(10): 614-23, 2013 Nov.
Article
en En
| MEDLINE
| ID: mdl-23869664
ABSTRACT
OBJECTIVES:
All HIV/hepatitis C virus (HCV)-coinfected patients with chronic HCV infection and ≥ F2 fibrosis should be considered for HCV therapy. This study aimed to determine the rate of HCV treatment uptake among coinfected patients in Europe.METHODS:
EuroSIDA patients with viraemic HCV infection were included in the study. Poisson regression was used to identify temporal changes and regional differences in HCV treatment uptake.RESULTS:
A total of 1984 patients were included in the study, with a median follow-up time of 168 months [interquartile range (IQR) 121-204 months]. To date, 501 (25.3%) HIV/HCV-coinfected patients have received HCV therapy. Treatment incidence rose from 0.33 [95% confidence interval (CI) 0.16-0.50] per 100 person-years of follow-up (PYFU) in 1998 to 5.93 (95% CI 4.49-7.38) in 2007, falling to 3.78 (95% CI 2.50-5.07) in 2009. After adjustment, CD4 cell count > 350 cells/µL [incidence rate ratio (IRR) 1.33 (95% CI 1.06-1.67) vs.â CD4 count 200-350 cells/µL] and ≥F2 liver fibrosis [IRR 1.60 (95% CI 1.14-2.25; P = 0.0065) vs. < F2 fibrosis] were predictors of anti-HCV treatment initiation. However, 22% of patients who remain untreated for HCV, with fibrosis data available, had ≥F2 fibrosis and should have been considered for treatment, while only 36% of treated patients had ≥F2 fibrosis.CONCLUSIONS:
Although treatment incidence for HCV has increased, there remain a large proportion of patients indicated for treatment who have yet to be treated.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Aceptación de la Atención de Salud
/
Infecciones por VIH
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Hepatitis C Crónica
/
Cirrosis Hepática
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
HIV Med
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2013
Tipo del documento:
Article
País de afiliación:
Reino Unido