Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"?

J Infect. 2017 Sep;75(3):234-241. doi: 10.1016/j.jinf.2017.05.008. Epub 2017 Jun 2.

Abstract

Objectives: Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients.

Methods: All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection.

Results: Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR.

Conclusions: HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.

Keywords: Coinfection; DAA; Direct acting antiviral agent; Epidemiology; HCV; HIV; Treatment uptake.

MeSH terms

  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Coinfection / drug therapy
  • Coinfection / epidemiology
  • Coinfection / virology
  • Female
  • France / epidemiology
  • Genotype
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / epidemiology
  • Hepatitis C / virology
  • Hepatitis C Antibodies / blood
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / virology
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Hepatitis C Antibodies