Advertisement

 

 

Non-invasive liver fibrosis assessment and HCV treatment initiation within a systematic screening program in HIV/HCV coinfected patients.

Non-invasive liver fibrosis assessment and HCV treatment initiation within a systematic screening program in HIV/HCV coinfected patients.
Author Information (click to view)

Chromy D, Schwabl P, Bucsics T, Scheiner B, Strassl R, Mayer F, Aichelburg MC, Grabmeier-Pfistershammer K, Trauner M, Peck-Radosavljevic M, Reiberger T, Mandorfer M,


Chromy D, Schwabl P, Bucsics T, Scheiner B, Strassl R, Mayer F, Aichelburg MC, Grabmeier-Pfistershammer K, Trauner M, Peck-Radosavljevic M, Reiberger T, Mandorfer M, (click to view)

Chromy D, Schwabl P, Bucsics T, Scheiner B, Strassl R, Mayer F, Aichelburg MC, Grabmeier-Pfistershammer K, Trauner M, Peck-Radosavljevic M, Reiberger T, Mandorfer M,

Advertisement

Wiener klinische Wochenschrift 2017 07 25() doi 10.1007/s00508-017-1231-x

Abstract
BACKGROUND AND AIM
Hepatitis C virus (HCV) therapy should be considered without delay in all patients with significant (SIGFIB) or advanced liver fibrosis (ADVFIB). We aimed to investigate the rates of treatment initiation with interferon-free regimens within a screening program for SIGFIB/ADVFIB in human immunodeficiency virus/HCV coinfected patients (HIV/HCV).

METHODS
The FIB-4 was calculated in all HIV/HCV from 2014-2016. HIV/HCV were counselled by the HIV clinic and referred to the Division of Gastroenterology and Hepatology for transient elastography (TE) and evaluation for HCV therapy. Patients were stratified by FIB-4 of 7.1 kPa/>9.5 kPa, respectively.

RESULTS
Among 1348 HIV+ patients, 16% (210/1348) had detectable HCV-RNA. One hundred HIV/HCV had a FIB-4 ≥1.45. Among these, 57% (57/100) underwent TE. The majority of these patients had SIGFIB (75%; 43/57) or ADVFIB (37%; 21/57), however, interferon-free treatment was initiated in only 56% (24/43). In addition, fifty-two percent (57/110) of HIV/HCV with FIB-4 <1.45 underwent TE. Interestingly, 40% (23/57) and 18% (10/57) of these patients showed SIGFIB or even ADVFIB, respectively, and 78% (18/23) finally received interferon-free treatment. Overall, only 20% (42/210) of HIV/HCV received interferon-free treatment. CONCLUSION
FIB-4 was not useful for ruling out SIGFIB/ADVFIB in our cohort of HIV/HCV. Treatment was initiated only in a small proportion (20%) of HIV/HCV during the first 2 years of interferon-free treatment availability, although the observed proportion of patients with SIGFIB (assessed by TE) was considerably higher (58%). Thus, it requires the ongoing combined efforts of both HIV and HCV specialists to increase treatment uptake rates in this special population.

Submit a Comment

Your email address will not be published. Required fields are marked *

1 × 2 =

[ HIDE/SHOW ]