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

Zinkernagel, A. S.
von Wyl, Viktor
Ledergerber, Bruno
Rickenbach, Martin
Furrer, Hansjakob
Battegay, Manuel
Tarr, P. E.
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Published in Antiviral therapy. 2006, vol. 11, no. 2, p. 131-142
Abstract 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-a 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 2150 of 7048 (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.
Keywords AdultAntiviral Agents/ therapeutic useCohort StudiesFemaleHIV Infections/ complicationsHepatitis C/ complications/ drug therapy/virologyHepatitis C Antibodies/bloodHumansInterferon Alfa-2a/therapeutic useInterferon Alfa-2b/therapeutic useMaleMiddle AgedPolyethylene Glycols/therapeutic useRNA, Viral/bloodRandomized Controlled Trials as TopicReproducibility of ResultsRibavirin/therapeutic useSwitzerland
PMID: 16640094
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ZINKERNAGEL, A. S. et al. Eligibility for and outcome of hepatitis C treatment of HIV-coinfected individuals in clinical practice: the Swiss HIV cohort study. In: Antiviral therapy, 2006, vol. 11, n° 2, p. 131-142. https://archive-ouverte.unige.ch/unige:7720

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Deposited on : 2010-06-21

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