Treatment rate for HCV in the direct-acting antivirals era in HIV co-infected patients: data from an Italian cohort.

Abstract

New direct antiviral agents (DAA) are now effective in hepatitis C virus (HCV) infection; persons living with human immunodeficiency virus (HIV) (PLWH) were undertreated. Aim of this study was to describe the management of HCV treatment in a HIV/HCV cohort during a 16 years period. An electronic review of all HIV patients with >1 clinic check from the year 2000 was made. Demographic, virologic and treatment data were collected. From 2000 to 2015 a total of 2352 PLWH were enrolled; 776 (33%) resulted positive at HCV antibodies, and were mostly genotype 1 and 3. 279/579 (48.2%) were treated, and 170 (29.3% of total, 60.9% of treated) obtained a SVR. Treatment rate for HCV had a significant increase in the 2015 (20.6%, P<0.05 when compared with previous years). SVR rate was significantly improved in the 2015 (P<0.05 when compared with each single previous year). At univariate analysis among the different year group there were significant differences in term of HCV RNA positive patients (P<0.001), number of treated (total) and naïve patients (P<0.001 in each of cases), SVR rate (P<0.001), mortality rate (P=0.003). HCV-Ab positive patients with HCV-RNA not detectable (cured) increased during years. At 2015, 50.4% of the HCV-Ab positive patients resulted to be HCV-RNA negative. In the DAA's era a significant increase in the number of treatments was observed. SVR rate was significantly higher. Treatment rate still remains quite low. More than a half of our population of HCV co-infected patients results to be cured for HCV.