Eligibility for and outcome of hepatitis C treatment of HIV-coinfected individuals in clinical practice: the Swiss HIV cohort study

被引:0
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作者
Zinkernagel, AS
von Wyl, V
Ledergerber, B
Rickenbach, M
Furrer, H
Battegay, M
Hirschel, B
Tarr, PE
Opravil, M
Bernasconi, E
Schmid, P
Weber, R [1 ]
机构
[1] Univ Zurich Hosp, Dept Internal Med, Div Infect Dis & Hosp Epidemiol, CH-8091 Zurich, Switzerland
[2] CHU Vaudois, Swiss HIV Cohort Study, Ctr Data, CH-1011 Lausanne, Switzerland
[3] Univ Hosp Bern, Klin & Poliklin Infektiol, CH-3010 Bern, Switzerland
[4] Univ Basel Hosp, Dept Internal Med, Div Infect Dis, CH-4031 Basel, Switzerland
[5] Univ Hosp, HCUGE, Div Infect Dis, Geneva, Switzerland
[6] CHU Vaudois, Div Infect Dis, CH-1011 Lausanne, Switzerland
[7] Osped Civ, Dept Internal Med, Div Infect Dis, Lugano, Switzerland
[8] Cantona Hosp, Dept Internal Med, Div Infect Dis & Hosp Epidemiol, St Gallen, Switzerland
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D O I
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中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Morbidity and mortality of individuals co-infected with HIV and hepatitis C virus (HCV) is often determined by the course of their HCV infection. Only a selected proportion of those in need of HCV treatment are studied in randomized controlled trials (RCTs). We analysed the prevalence of HCV infection in a large cohort, the number of individuals requiring treatment, the eligibility for HCV treatment, and the outcome of the combination therapy with pegylated interferon-alpha and ribavirin in routine practice. Methods: We analysed prescription patterns of HCV treatment and treatment outcomes among participants from the Swiss HIV Cohort Study with detectable hepatitis C viraemia (between January 2001 and October 2004). Efficacy was measured by the number of patients with undetectable HCV RNA at the end of therapy (EOTR) and at 6 months after treatment termination (SVR). Intention-to-continue-treatment principles were used. Results: A total of 2,150 of 7,048 (30.5%) participants were coinfected with HCV; HCV RNA was detected in 60%, and not assessed in 26% of HCV-antibody-positive individuals. One hundred and sixty (12.5%) of HCV-RNA-positive patients started treatment. In patients infected with HCV genotypes 1/4 or 2/3, EOTR was achieved in 43.3% and 81.2% of patients, respectively, and SVR rates were 28.4% and 51.8%, respectively. More than 50% of the HCV-treated patients would have been excluded from two large published RCTs due to demographic, clinical and laboratory criteria. Conclusions: Despite clinical and psychosocial obstacles encountered in clinical practice, HCV treatment in HIV-coinfected individuals is feasible with results similar to those obtained in RCTs.
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页码:131 / 142
页数:12
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