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Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA

(2013) HIV MEDICINE. 14(10). p.614-623
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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 >350cells/L [incidence rate ratio (IRR) 1.33 (95% CI 1.06-1.67) vs.CD4 count 200-350 cells/L] 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.
Keywords
ribavirin, PEG-interferon, treatment completion, HUMAN-IMMUNODEFICIENCY-VIRUS, HIV-INFECTED PATIENTS, PLUS RIBAVIRIN, PEGYLATED INTERFERON-ALPHA-2B, ANTIRETROVIRAL THERAPY, VIRAL CLEARANCE, LOW ELIGIBILITY, LIVER FIBROSIS, COINFECTION, HCV, EuroSIDA, HCV coinfection, HIV

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Citation

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Chicago
Grint, D, L Peters, C Schwarze-Zander, M Beniowski, C Pradier, M Battegay, D Jevtovic, et al. 2013. “Temporal Changes and Regional Differences in Treatment Uptake of Hepatitis C Therapy in EuroSIDA.” Hiv Medicine 14 (10): 614–623.
APA
Grint, D, Peters, L., Schwarze-Zander, C., Beniowski, M., Pradier, C., Battegay, M., Jevtovic, D., et al. (2013). Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA. HIV MEDICINE, 14(10), 614–623.
Vancouver
1.
Grint D, Peters L, Schwarze-Zander C, Beniowski M, Pradier C, Battegay M, et al. Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA. HIV MEDICINE. 2013;14(10):614–23.
MLA
Grint, D, L Peters, C Schwarze-Zander, et al. “Temporal Changes and Regional Differences in Treatment Uptake of Hepatitis C Therapy in EuroSIDA.” HIV MEDICINE 14.10 (2013): 614–623. Print.
@article{4351620,
  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 {\textrangle}350cells/L [incidence rate ratio (IRR) 1.33 (95\% CI 1.06-1.67) vs.CD4 count 200-350 cells/L] and F2 liver fibrosis [IRR 1.60 (95\% CI 1.14-2.25; P=0.0065) vs. {\textlangle}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.},
  author       = {Grint, D and Peters, L and Schwarze-Zander, C and Beniowski, M and Pradier, C and Battegay, M and Jevtovic, D and Soriano, V and Lundgren, JD and Rockstroh, JK and Kirk, O and Mocroft, A and EuroSIDA study group, the and Vandekerckhove, Linos},
  issn         = {1464-2662},
  journal      = {HIV MEDICINE},
  keyword      = {ribavirin,PEG-interferon,treatment completion,HUMAN-IMMUNODEFICIENCY-VIRUS,HIV-INFECTED PATIENTS,PLUS RIBAVIRIN,PEGYLATED INTERFERON-ALPHA-2B,ANTIRETROVIRAL THERAPY,VIRAL CLEARANCE,LOW ELIGIBILITY,LIVER FIBROSIS,COINFECTION,HCV,EuroSIDA,HCV coinfection,HIV},
  language     = {eng},
  number       = {10},
  pages        = {614--623},
  title        = {Temporal changes and regional differences in treatment uptake of hepatitis C therapy in EuroSIDA},
  url          = {http://dx.doi.org/10.1111/hiv.12068},
  volume       = {14},
  year         = {2013},
}

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