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More coinfected patients receiving treatment for acute HCV
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GLASGOW — Treatment incidence for acute hepatitis C virus among coinfected patients increased from 1998 to 2007 and appears to be more frequent in patients with higher CD4 counts and lower HIV-RNA, which is in line with current guidelines, according to data presented here.
A study examining temporal changes and regional differences in HCV treatment included 1,947 participants from EuroSIDA, a prospective, observational, cohort study. All patients were positive for HCV antibody and HCV-RNA. Of the patients included, 44% had HCV genotype 1 and 73% were IV drug users.
More than 23% of HIV/HCV coinfected patients received HCV treatment during a median follow-up of 107 months.
The incidence of HCV treatment increased from 0.29 (95% CI, 0.13-0.45) per 100 person-years of follow-up in 1998 to 5.26 (95% CI, 3.87-6.5) in 2007, before decreasing to 3.73 (95% CI, 2.4-5.06) in 2009, according to the study abstract. During a presentation, Daniel Grint, research assistant of the research department of infection and population health, Royal Free Hospital, London, said the researchers calculated an accrued incidence rate ratio (IRR) of 1.27, translating to a significant 26% increase per year in the uptake of HCV treatment. From 2007 to 2010, the uptake of treatment stabilized, with rates declining to 4.7 per 100 person-years in 2010. This accrued IRR was 1.88, translating to a significant 12% reduction per year during the later time period, Grint said during the session.
“Potential reasons [for the stabilization] could be that the eligible population for treatment for HCV could have been saturated or that with the promise of new regimens around the corner, like interferon 3, clinicians could be choosing to defer therapy until they have a more favorable option,” he said.
Patients with HIV-RNA <500 copies/mL, HCV genotype 3 and those living in southern Europe were more likely to initiate treatment.
The researchers also estimated the effect of HCV treatment on all-cause and liver-related mortality and reported a 27% reduction for all-cause mortality and 58% reduction for liver-related mortality, according to Grint.
For more information:
Grint D. #O243. Presented at: HIV11 Congress; Nov. 11-15, 2012; Glasgow.
Disclosure: Grint reports no relevant financial disclosures.