The hepatitis C cascade of care in HIV/hepatitis C virus coinfected individuals in Europe: regional and intra-regional differences

Following the introduction of direct-acting antiviral therapy in 2013, WHO launched the first Global Health Sector Strategy on Viral Hepatitis. We describe a hepatitis C virus (HCV) cascade of care in people with HIV (PWH) across Europe in terms of reaching the WHO elimination targets of diagnosing...

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Vydáno v:AIDS (London) Ročník 36; číslo 3; s. 423
Hlavní autoři: Fursa, Olga, Mocroft, Amanda, Lazarus, Jeffrey V, Amele, Sarah, Lundgren, Jens, Matulionyte, Raimonda, Rasmussen, Line D, Rockstroh, Jürgen K, Parczewski, Milosz, Jilich, David, Moreno, Santiago, Vassilenko, Anna, Lacombe, Karine, Wandeler, Gilles, Borodulina, Elena, Brännström, Johanna, Wiese, Lothar, Orkin, Chloe, Behrens, Georg M N, Mansinho, Kamal, Portu, Jose Joaquin, Peters, Lars
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.03.2022
Témata:
Antiviral Agents - therapeutic use
Coinfection - drug therapy
Europe - epidemiology
Hepacivirus - genetics
Hepatitis C - complications
Hepatitis C - drug therapy
Hepatitis C - epidemiology
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - epidemiology
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - epidemiology
Humans
Prospective Studies
RNA - therapeutic use
Europe
ISSN:1473-5571, 1473-5571
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Shrnutí:Following the introduction of direct-acting antiviral therapy in 2013, WHO launched the first Global Health Sector Strategy on Viral Hepatitis. We describe a hepatitis C virus (HCV) cascade of care in people with HIV (PWH) across Europe in terms of reaching the WHO elimination targets of diagnosing 90% and treating 80% of HCV-infected individuals. HIV/HCV-coinfected participants in the EuroSIDA cohort under prospective follow-up at October 1, 2019, were described using a nine-stage cascade of care. Care cascades were constructed across Europe, on a regional (n = 5) and country (n = 21) level. Of 4773 anti-HCV positive PWH, 4446 [93.1%, 95% confidence interval (CI) 92.4-93.9)] were ever tested for HCV RNA, and 19.0% (95% CI 16.4-21.6) were currently HCV RNA positive, with the highest prevalence in Eastern and Central-Eastern Europe (33.7 and 29.6%, respectively). In Eastern Europe, 78.1% of the estimated number of chronic infections have been diagnosed, whereas this proportion was above 95% in the other four regions. Overall, 3116 persons have ever started treatment (72.5% of the ever chronically infected, 95% CI 70.9-74.0) and 2404 individuals (55.9% of the ever chronically infected, 95% CI 53.9-57.9) were cured. Cure proportion ranged from 11.2% in Belarus to 87.2% in Austria. In all regions except Eastern Europe, more than 90% of the study participants have been tested for HCV-RNA. In Southern and Central-Western regions, more than 80% ever chronically HCV-infected PWH received treatment. The proportion with cured HCV infection did not exceed 80% in any region, with significant heterogeneity between countries. In a pan-European cohort of PWH, all regions except Eastern Europe achieved the WHO target of diagnosing 90% of chronic HCV infections, while the target of treating 80% of eligible persons was achieved in none of the five regions.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1473-5571
1473-5571
DOI:10.1097/QAD.0000000000003112