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

D Grint, L Peters, C Schwarze-Zander, M Beniowski, C Pradier, M Battegay, D Jevtovic, V Soriano, JD Lundgren, JK Rockstroh, et al. (2013) HIV MEDICINE. 14(10). p.614-623
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
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
journal title
HIV MEDICINE
HIV Med.
volume
14
issue
10
pages
614 - 623
Web of Science type
Article
Web of Science id
000325492300004
JCR category
INFECTIOUS DISEASES
JCR impact factor
3.454 (2013)
JCR rank
20/72 (2013)
JCR quartile
2 (2013)
ISSN
1464-2662
DOI
10.1111/hiv.12068
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
4351620
handle
http://hdl.handle.net/1854/LU-4351620
date created
2014-04-02 15:48:03
date last changed
2016-12-19 15:38:32
@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},
}

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.