Abstract

Background. The hepatitis C virus (HCV) epidemic is evolving rapidly in patients infected with human immunodeficiency virus (HIV). We aimed to describe changes in treatment uptake and outcomes of incident HCV infections before and after 2006, the time-point at which major changes in HCV epidemic became apparent.

Methods. We included all adults with an incident HCV infection before June 2012 in the Swiss HIV Cohort Study, a prospective nationwide representative cohort of individuals infected with HIV. We assessed the following outcomes by time period: the proportion of patients starting an HCV therapy, the proportion of treated patients achieving a sustained virological response (SVR), and the proportion of patients with persistent HCV infection during follow-up.

Results. Of 193 patients with an HCV seroconversion, 106 were diagnosed before and 87 after January 2006. The proportion of men who have sex with men increased from 24% before to 85% after 2006 (P < .001). Hepatitis C virus treatment uptake increased from 33% before 2006 to 77% after 2006 (P < .001). Treatment was started during early infection in 22% of patients before and 91% after 2006 (P < .001). An SVR was achieved in 78% and 29% (P = .01) of patients treated during early and chronic HCV infection. The probability of having a detectable viral load 5 years after diagnosis was 0.67 (95% confidence interval [CI], 0.58–0.77) in the group diagnosed before 2006 and 0.24 (95% CI, 0.16–0.35) in the other group (P < .001).

Conclusions. In recent years, increased uptake and earlier initiation of HCV therapy among patients with incident infections significantly reduced the proportion of patients with replicating HCV.

Details

Title
Incident Hepatitis C Virus Infections in the Swiss HIV Cohort Study: Changes in Treatment Uptake and Outcomes Between 1991 and 2013
Author
Wandeler, Gilles 1 ; Schlauri, Marion 2 ; Marie-Eve Jaquier 2 ; Rohrbach, Janine 2 ; Metzner, Karin J 3 ; Fehr, Jan 3 ; Ambrosioni, Juan 4 ; Cavassini, Matthias 5 ; Stöckle, Marcel 6 ; Schmid, Patrick 7 ; Bernasconi, Enos 8 ; Keiser, Olivia 9 ; Salazar-Vizcaya, Luisa 9 ; Furrer, Hansjakob 2 ; Rauch, Andri 2 

 Department of Infectious Diseases, Bern University Hospital and University of Bern; Institute of Social and Preventive Medicine, University of Bern 
 Department of Infectious Diseases, Bern University Hospital and University of Bern 
 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich 
 University Hospital Geneva 
 University Hospital Lausanne 
 University Hospital Basel 
 Cantonal Hospital, St. Gallen 
 Regional Hospital, Lugano, Switzerland 
 Institute of Social and Preventive Medicine, University of Bern 
Publication year
2015
Publication date
Winter 2015
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170969381
Copyright
© The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.