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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| Veröffentlicht in: | AIDS (London) Jg. 36; H. 3; S. 423 |
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01.03.2022
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| Abstract | 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. |
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| AbstractList | 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.BACKGROUNDFollowing 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.METHODSHIV/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.RESULTSOf 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.CONCLUSIONIn 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.SUMMARYIn 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. 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. |
| Author | Rasmussen, Line D Mansinho, Kamal Orkin, Chloe Mocroft, Amanda Peters, Lars Fursa, Olga Matulionyte, Raimonda Behrens, Georg M N Portu, Jose Joaquin Rockstroh, Jürgen K Wandeler, Gilles Vassilenko, Anna Lundgren, Jens Amele, Sarah Moreno, Santiago Parczewski, Milosz Brännström, Johanna Lacombe, Karine Borodulina, Elena Lazarus, Jeffrey V Wiese, Lothar Jilich, David |
| Author_xml | – sequence: 1 givenname: Olga surname: Fursa fullname: Fursa, Olga organization: Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark – sequence: 2 givenname: Amanda surname: Mocroft fullname: Mocroft, Amanda organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK – sequence: 3 givenname: Jeffrey V surname: Lazarus fullname: Lazarus, Jeffrey V organization: Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain – sequence: 4 givenname: Sarah surname: Amele fullname: Amele, Sarah organization: Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK – sequence: 5 givenname: Jens surname: Lundgren fullname: Lundgren, Jens organization: Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark – sequence: 6 givenname: Raimonda surname: Matulionyte fullname: Matulionyte, Raimonda organization: Vilnius University, Faculty of Medicine, Department of Infectious Diseases and Dermatovenerology, Vilnius, Lithuania – sequence: 7 givenname: Line D surname: Rasmussen fullname: Rasmussen, Line D organization: Department of Infectious Diseases, Odense University Hospital, Odense, Denmark – sequence: 8 givenname: Jürgen K surname: Rockstroh fullname: Rockstroh, Jürgen K organization: Department of Medicine, University Hospital Bonn, Bonn, Germany – sequence: 9 givenname: Milosz surname: Parczewski fullname: Parczewski, Milosz organization: Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland – sequence: 10 givenname: David surname: Jilich fullname: Jilich, David organization: Charles University in Prague and Na Bulovce Hospital, Prague, Czech Republic – sequence: 11 givenname: Santiago surname: Moreno fullname: Moreno, Santiago organization: Servicio Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain – sequence: 12 givenname: Anna surname: Vassilenko fullname: Vassilenko, Anna organization: Belarusian State Medical University, Minsk, Belarus – sequence: 13 givenname: Karine surname: Lacombe fullname: Lacombe, Karine organization: Sorbonne Université, IPLESP Inserm UMR-S1136, AP-HP, Paris, France – sequence: 14 givenname: Gilles surname: Wandeler fullname: Wandeler, Gilles organization: Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland – sequence: 15 givenname: Elena surname: Borodulina fullname: Borodulina, Elena organization: Samara State Medical University, Samara, Russia – sequence: 16 givenname: Johanna surname: Brännström fullname: Brännström, Johanna organization: Department of Infectious Diseases/Venhälsan, Södersjukhuset, Stockholm, Sweden – sequence: 17 givenname: Lothar surname: Wiese fullname: Wiese, Lothar organization: Sjællands Universitetshospital, Roskilde, Denmark – sequence: 18 givenname: Chloe surname: Orkin fullname: Orkin, Chloe organization: Royal London Hospital, London, UK – sequence: 19 givenname: Georg M N surname: Behrens fullname: Behrens, Georg M N organization: Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany – sequence: 20 givenname: Kamal surname: Mansinho fullname: Mansinho, Kamal organization: Hospital de Egas Moniz, Lisbon, Portugal – sequence: 21 givenname: Jose Joaquin surname: Portu fullname: Portu, Jose Joaquin organization: Hospital Universitario de Alava, Vitoria-Gasteiz, Spain – sequence: 22 givenname: Lars surname: Peters fullname: Peters, Lars organization: Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark |
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| SubjectTerms | 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 |
| Title | The hepatitis C cascade of care in HIV/hepatitis C virus coinfected individuals in Europe: regional and intra-regional differences |
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