Treatment of hepatitis C virus in human immunodeficiency virus infected patients in "real life": modifications in two large surveys between 2004 and 2006

J Hepatol. 2008 Jan;48(1):35-42. doi: 10.1016/j.jhep.2007.07.028. Epub 2007 Oct 2.

Abstract

Background/aims: To analyze the barriers to HCV treatment in HIV-HCV co-infected patients and their evolution between 2004 and 2006.

Methods: Three hundred and eighty HIV-HCV co-infected patients were prospectively included in surveys from November 22 to 29, 2004 (2004 survey), and 416 from April 3 to 10, 2006 (2006 survey).

Results: Patients in 2006 compared to those in 2004 had negative HCV RNA more often (24% vs. 12%). The rate of liver biopsy was similar (56% vs. 54%) while 24% had had a non-invasive liver damage assessment. The rate of previous treatment for HCV infection was higher (48% vs. 26%). The main reasons for HCV non-treatment have changed: HCV treatment deemed questionable (44% vs. 53%), lack of liver biopsy (18% vs. 33%), physicians' conviction of poor patient compliance (20% vs. 30%). In both surveys, HCV treated patients were more often of European origin, had better control of HIV infection, and had a liver damage assessment more often.

Conclusions: The care of HIV-HCV co-infected patients has changed significantly in "real life". These results underline the importance of continuing efforts to educate physicians and patients in order to increase the access of co-infected patients to HCV treatment.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Attitude of Health Personnel
  • Biopsy
  • CD4 Antigens / analysis
  • Female
  • France
  • Genotype
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Health Care Surveys
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology
  • Hepatitis C / therapy*
  • Humans
  • Interferons / therapeutic use
  • Liver / pathology
  • Male
  • Middle Aged
  • RNA, Viral / blood
  • Viral Load

Substances

  • Antiviral Agents
  • CD4 Antigens
  • RNA, Viral
  • Interferons