Human immunodeficiency virus/hepatits C virus coinfection in Spain: Elimination is feasible, but the burden of residual cirrhosis will be significant

Berenguer, J. ; Jarrín, I. ; Pérez-Latorre, L. ; Hontañón, V. ; Vivancos, M.J. ; Navarro, J. ; Téllez, M.J. ; Guardiola, J.M. ; Iribarren, J.A. ; Rivero-Juárez, A. ; Márquez, M. ; Artero, A. ; Morano, L. ; Santos, I. ; Moreno, J. (Universidad de Zaragoza) ; Fariñas, M.C. ; Galindo, M.J. ; Hernando, M.A. ; Montero, M. ; Cifuentes, C. ; Domingo, P. ; Sanz, J. ; Domíngez, L. ; Ferrero, O.L. ; De La Fuente, B. ; Rodríguez, C. ; Reus, S. ; Hernández-Quero, J. ; Gaspar, G. ; Pérez-Martínez, L. ; García, C. ; Force, L. ; Veloso, S. ; Losa, J.E. ; Vilaró, J. ; Bernal, E. ; Arponen, S. ; Ortí, A.J. ; Chocarro, Á. ; Teira, R. ; Alonso, G. ; Silvariño, R. ; Vegas, A. ; Geijo, P. ; Bisbe, J. ; Esteban, H. ; González-García, J.

Resumen: Background
We assessed the prevalence of antibodies against hepatitis C virus (HCV-Abs) and active HCV infection in patients infected with human immunodeficiency virus (HIV) in Spain in 2016 and compared the results with those of similar studies performed in 2002, 2009, and 2015.
Methods
The study was performed in 43 centers during October-November 2016. The sample was estimated for an accuracy of 2% and selected by proportional allocation and simple random sampling. During 2016, criteria for therapy based on direct-acting antiviral agents (DAA) were at least significant liver fibrosis, severe extrahepatic manifestations of HCV, and high risk of HCV transmissibility.
Results
The reference population and the sample size were 38904 and 1588 patients, respectively. The prevalence of HCV-Abs in 2002, 2009, 2015, and 2016 was 60.8%, 50.2%, 37.7%, and 34.6%, respectively (P trend <.001, from 2002 to 2015). The prevalence of active HCV in 2002, 2009, 2015, and 2016 was 54.0%, 34.0%, 22.1%, and 11.7%, respectively (P trend <.001). The anti-HCV treatment uptake in 2002, 2009, 2015, and 2016 was 23.0%, 48.0%, 59.3%, and 74.7%, respectively (P trend <.001). In 2016, HCV-related cirrhosis was present in 7.6% of all HIV-infected individuals, 15.0% of patients with active HCV, and 31.5% of patients who cleared HCV after anti-HCV therapy.
Conclusions
Our findings suggest that with universal access to DAA-based therapy and continued efforts in prevention and screening, it will be possible to eliminate active HCV among HIV-infected individuals in Spain in the short term. However, the burden of HCV-related cirrhosis will continue to be significant among HIV-infected individuals.

Idioma: Inglés

DOI: 10.1093/ofid/ofx258

Año: 2018

Publicado en: Open Forum Infectious Diseases 5, 1 (2018), [8 pp]
ISSN: 2328-8957

Factor impacto JCR: 3.371 (2018)

Categ. JCR: IMMUNOLOGY rank: 73 / 157 = 0.465 (2018) - Q2 - T2
Categ. JCR: MICROBIOLOGY rank: 46 / 133 = 0.346 (2018) - Q2 - T2
Categ. JCR: INFECTIOUS DISEASES rank: 29 / 89 = 0.326 (2018) - Q2 - T1

Factor impacto SCIMAGO: 1.48 - Oncology (Q1) - Neurology (clinical) (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER/RD16-0025-0017
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER/RD16-0025-0018

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)