Titre
Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Béguelin, C.
Auteure/Auteur
Suter, A.
Auteure/Auteur
Bernasconi, E.
Auteure/Auteur
Fehr, J.
Auteure/Auteur
Kovari, H.
Auteure/Auteur
Bucher, H.C.
Auteure/Auteur
Stoeckle, M.
Auteure/Auteur
Cavassini, M.
Auteure/Auteur
Rougemont, M.
Auteure/Auteur
Schmid, P.
Auteure/Auteur
Wandeler, G.
Auteure/Auteur
Rauch, A.
Auteure/Auteur
Contributrices/contributeurs
Aubert, V.
Battegay, M.
Böni, J.
Braun, D.L.
Calmy, A.
Ciuffi, A.
Dollenmaier, G.
Egger, M.
Elzi, L.
Fellay, J.
Furrer, H.
Fux, C.A.
Günthard, H.F.
Haerry, D.
Hasse, B.
Hirsch, H.H.
Hoffmann, M.
Hösli, I.
Kahlert, C.
Kaiser, L.
Keiser, O.
Klimkait, T.
Kouyos, R.D.
Ledergerber, B.
Martinetti, G.
Tejada, B.
Marzolini, C.
Metzner, K.J.
Müller, N.
Nicca, D.
Pantaleo, G.
Paioni, P.
Rudin, C.
Scherrer, A.U.
Speck, R.
Stöckle, M.
Tarr, P.
Trkola, A.
Vernazza, P.
Weber, R.
Yerly, S.
Groupes de travail
Swiss HIV Cohort Study
Liens vers les personnes
Liens vers les unités
ISSN
1478-3231
Statut éditorial
Publié
Date de publication
2018-03
Volume
38
Numéro
3
Première page
424
Dernière page/numéro d’article
431
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Hepatitis C virus (HCV) therapies with interferon-free second-generation direct-acting antivirals (DAAs) are highly effective and well tolerated. They have the potential to increase treatment eligibility and efficacy in HIV-infected patients. We assessed the impact of DAAs on treatment uptake and efficacy, as well as its impact on the burden of liver disease in the Swiss HIV Cohort Study (SHCS).
We describe clinical and virological characteristics of patients treated with second-generation DAAs. We compared treatment incidence, sustained virological response (SVR)12 and liver fibrosis stages between three time periods: period 1, 01/2009-08/2011 (prior to the availability of DAAs); period 2, 09/2011-03/2014 (first generation DAAs); period 3, 04/2014-12/2015 (second generation DAAs).
At the beginning of the third period, 876 SHCS participants had a chronic HCV infection of whom 180 (20%) started treatment with a second-generation DAA. Three-quarters of them had advanced liver fibrosis (Metavir ≥ F3) of whom 80% were cirrhotics. SVR12 was achieved in 173/180 (96%) patients, three patients died and four experienced a virological failure. Over the three time periods, treatment uptake (4.5/100 py, 5.7/100 py, 22.4/100 py) and efficacy (54%, 70%, 96% SVR12) continuously increased. The proportion of cirrhotic patients with replicating HCV infection in the SHCS declined from 25% at the beginning to 12% at the end of the last period.
After the introduction of second-generation DAAs, we observed an increase in treatment uptake and efficacy which resulted in a significant reduction in the number of cirrhotic patients with a replicating HCV infection in the SHCS.
We describe clinical and virological characteristics of patients treated with second-generation DAAs. We compared treatment incidence, sustained virological response (SVR)12 and liver fibrosis stages between three time periods: period 1, 01/2009-08/2011 (prior to the availability of DAAs); period 2, 09/2011-03/2014 (first generation DAAs); period 3, 04/2014-12/2015 (second generation DAAs).
At the beginning of the third period, 876 SHCS participants had a chronic HCV infection of whom 180 (20%) started treatment with a second-generation DAA. Three-quarters of them had advanced liver fibrosis (Metavir ≥ F3) of whom 80% were cirrhotics. SVR12 was achieved in 173/180 (96%) patients, three patients died and four experienced a virological failure. Over the three time periods, treatment uptake (4.5/100 py, 5.7/100 py, 22.4/100 py) and efficacy (54%, 70%, 96% SVR12) continuously increased. The proportion of cirrhotic patients with replicating HCV infection in the SHCS declined from 25% at the beginning to 12% at the end of the last period.
After the introduction of second-generation DAAs, we observed an increase in treatment uptake and efficacy which resulted in a significant reduction in the number of cirrhotic patients with a replicating HCV infection in the SHCS.
Sujets
PID Serval
serval:BIB_62355A30C0EF
PMID
Date de création
2017-08-07T09:01:57.042Z
Date de création dans IRIS
2025-05-21T02:25:22Z
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