Hepatitis C virus (HCV) treatment uptake and changes in the prevalence of HCV genotypes in HIV/HCV-coinfected patients.

Abstract

The efficacy of current hepatitis C therapy in HIV/HCV-coinfected patients is largely dependent on HCV genotype. The annual prevalence of HCV genotypes/subtypes and their influence on HCV clearance with antiviral treatment were examined in a dynamic cohort of HIV/HCV-coinfected patients followed up in Madrid since 2000. Patients entered the cohort at first visit and left the cohort when HCV clearance was achieved with HCV therapy or when follow-up was interrupted for any reason, including death. A total of 672 HIV/HCV-coinfected patients constituted the cohort. The mean follow-up time was 5.5 years, corresponding to 4108 patient-years. Mean age at entry was 37 years, and 73% were men and 86% were intravenous drug users. Overall distribution of HCV genotypes was as follows: 57.1% HCV-1 (1a: 29.2%, 1b: 20.4%, unknown: 7.6%), 1.3% HCV-2, 25.4% HCV-3 and 15.9% HCV-4. A total of 274 (40.8%) patients were treated with peginterferon-ribavirin, of whom 116 (42.3%) achieved HCV clearance following 1-3 courses of therapy. The proportion of HCV-1/4 rose from 71.7% in 2000 to 76.8% in 2008, whereas the proportion of HCV-2/3 fell from 28.1% in 2000 to 23.2% in 2008. The yearly prevalence increased for HCV-1 (R(2) : 0.92, b: 0.59, P < 0.001) and HCV-4 (R(2) : 0.77, b: 0.33, P < 0.005) and conversely diminished for HCV-3 (R(2) : 0.94, b: -0.82, P < 0.001). In summary, the prevalence of HCV-1 and HCV-4 has increased over the last decade in HIV/HCV-coinfected patients, whereas conversely it has declined for HCV-3, in association with the wider use of HCV therapy (41%) in this population.

• Authors: J Medrano, S Resino, E Vispo, A Madejón, P Labarga, P Tuma, L Martín-Carbonero, P Barreiro, S Rodriguez-Novoa, I Jiménez-Nacher, V Soriano
• Journal: Journal of viral hepatitis (J Viral Hepat) Vol. 18 Issue 5 Pg. 325-30 (May 2011) ISSN: 1365-2893 [Electronic] England
• PMID: 20456635 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 Blackwell Publishing Ltd.

Chemical References

• Antiviral Agents
• RNA, Viral
• Ribavirin
• Interferons

Topics

• Adult
• Antiviral Agents (administration & dosage, therapeutic use)
• Cohort Studies
• Drug Therapy, Combination (trends)
• Follow-Up Studies
• Genotype
• HIV Infections (complications, epidemiology)
• HIV Seropositivity
• Hepacivirus (classification, drug effects, genetics)
• Hepatitis C (complications, drug therapy, epidemiology, virology)
• Humans
• Incidence
• Interferons (therapeutic use)
• Male
• Population Dynamics
• Prevalence
• RNA, Viral (blood, genetics)
• Ribavirin (therapeutic use)
• Substance Abuse, Intravenous