Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

25.07.2017 | original article | Ausgabe 3-4/2018 Open Access

Wiener klinische Wochenschrift 3-4/2018

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

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 3-4/2018
Autoren:
David Chromy, M.D. Philipp Schwabl, M.D. Theresa Bucsics, M.D. Bernhard Scheiner, M.D. Robert Strassl, M.D. Florian Mayer, M.D. Maximilian C. Aichelburg, M.D. Katharina Grabmeier-Pfistershammer, M.D. Michael Trauner, M.D. Markus Peck-Radosavljevic, M.D. Thomas Reiberger, M.D. Mattias Mandorfer
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi: 10.​1007/​s00508-017-1231-x) contains supplementary material, which is available to authorized users.

Summary

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 </≥1.45 (established cut-off for ruling out ADVFIB) and SIGFIB/ADVFIB were defined by liver stiffness >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.

Unsere Produktempfehlungen

Abo für kostenpflichtige Inhalte

Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 3-4/2018

Wiener klinische Wochenschrift 3-4/2018 Zur Ausgabe

MUW researcher of the month

MUW researcher of the month