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Parenteral drug use as the main barrier to hepatitis C treatment uptake in HIV-infected patients.

Abstract：

OBJECTIVES:Our objective was to identify patient factors associated with being untreated for hepatitis C virus (HCV) infection in HIV-coinfected patients. METHODS:A prospective longitudinal study was carried out. HIV-infected patients with active chronic HCV infection included in the HERACLES cohort (NCT02511496) constituted the study population. The main study outcome was receipt of HCV direct-acting antiviral (DAA) treatment from 1 May 2015 to 1 May 2017. The population was divided into patients who were receiving HCV treatment during follow-up and those who were not. RESULTS:Of the 15 556 HIV-infected patients in care, 3075 (19.7%) presented with chronic HCV infection and constituted the study population. At the end of the follow-up, 1957 patients initiated HCV therapy (63.6%). Age < 50 years, absence of or minimal liver fibrosis, being treatment-naïve, HCV genotype 3 infection, being in the category of people who inject drugs using opioid substitutive therapy (OST-PWID), and being in the category of recent PWID were identified as significant independent risk factors associated with low odds of DAA implementation. When a multivariate analysis was performed including only the PWID population, both OST-PWID [odds ratio (OR) 0.552; 95% confidence interval (CI) 0.409-0.746) and recent PWID (OR 0.019; 95% CI 0.004-0.087) were identified as independent factors associated with low odds of treatment implementation. CONCLUSIONS:We identified factors, which did not include prioritization of a DAA uptake strategy, that limited access to HCV therapy. The low treatment uptake in several populations seriously jeopardizes the elimination of HCV infection in the coming years.

journal_name

HIV Med

journal_title

HIV medicine

authors

Rivero-Juarez A,Tellez F,Castaño-Carracedo M,Merino D,Espinosa N,Santos J,Macias J,Paniagua-García M,Zapata-Lopez A,Collado A,Gómez-Vidal MA,Perez-Stachowski J,Muñoz-Medina L,Fernandez-Fuertes E,Rivero A,Grupo de estudio de

doi

10.1111/hiv.12715

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

359-367

issue

eissn

1464-2662

issn

1468-1293

journal_volume

pub_type

杂志文章,多中心研究

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Parenteral drug use as the main barrier to hepatitis C treatment uptake in HIV-infected patients.