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. 2018 Jan 12;5(1):ofx258.
doi: 10.1093/ofid/ofx258. eCollection 2018 Jan.

Human Immunodeficiency Virus/Hepatits C Virus Coinfection in Spain: Elimination Is Feasible, but the Burden of Residual Cirrhosis Will Be Significant

Juan Berenguer  1 , Inmaculada Jarrín  2 , Leire Pérez-Latorre  1 , Víctor Hontañón  3 , María J Vivancos  4 , Jordi Navarro  5 , María J Téllez  6 , Josep M Guardiola  7 , José A Iribarren  8 , Antonio Rivero-Juárez  9 , Manuel Márquez  10 , Arturo Artero  11 , Luis Morano  12 , Ignacio Santos  13 , Javier Moreno  14 , María C Fariñas  15 , María J Galindo  16 , María A Hernando  17 , Marta Montero  18 , Carmen Cifuentes  19 , Pere Domingo  20 , José Sanz  21 , Lourdes Domíngez  22 , Oscar L Ferrero  23 , Belén De la Fuente  24 , Carmen Rodríguez  25 , Sergio Reus  26 , José Hernández-Quero  27 , Gabriel Gaspar  28 , Laura Pérez-Martínez  29 , Coral García  30 , Lluis Force  31 , Sergio Veloso  32 , Juan E Losa  33 , Josep Vilaró  34 , Enrique Bernal  35 , Sari Arponen  36 , Amat J Ortí  37 , Ángel Chocarro  38 , Ramón Teira  39 , Gerardo Alonso  40 , Rafael Silvariño  41 , Ana Vegas  42 , Paloma Geijo  43 , Josep Bisbe  44 , Herminia Esteban  45 , Juan González-García  3 ; GeSIDA 8514 Study Group
Affiliations

Human Immunodeficiency Virus/Hepatits C Virus Coinfection in Spain: Elimination Is Feasible, but the Burden of Residual Cirrhosis Will Be Significant

Juan Berenguer et al. Open Forum Infect Dis. .

Abstract

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.

Keywords: HIV infection/*epidemiology; Spain/epidemiology; coinfection/*epidemiology; hepatitis C/drug therapy/*epidemiology.

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Figures

Figure 1.
Figure 1.
Principal human immunodeficiency virus transmission categories in the cross-sectional studies carried out by Grupo de Estudio del SIDA in 2002, 2009, 2015, and 2016. IDU, injection drug use; MSM, men who have sex with men.
Figure 2.
Figure 2.
Prevalence of hepatitis C virus (HCV) seropositivity and active HCV infection in the cross-sectional studies carried out by Grupo de Estudio del SIDA in 2002, 2009, 2015, and 2016. HCV Ab+, presence of antibodies against HCV; HCV-RNA+, detectable HCV-RNA; RNA, ribonucleic acid.
Figure 3.
Figure 3.
Anti-hepatitis C virus (HCV) treatment uptake in the cross-sectional studies carried out by Grupo de Estudio del SIDA in 2002, 2009, 2015, and 2016. Treatment uptake was defined as the proportion of patients with current or past chronic HCV infection exposed to anti-HCV therapy
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References

    1. Sulkowski MS, Mast EE, Seeff LB, Thomas DL. Hepatitis C virus infection as an opportunistic disease in persons infected with human immunodeficiency virus. Clin Infect Dis 2000; 30(Suppl 1):S77–84. - PubMed
    1. Kim AY, Onofrey S, Church DR. An epidemiologic update on hepatitis C infection in persons living with or at risk of HIV infection. J Infect Dis 2013; 207(Suppl 1):S1–6. - PMC - PubMed
    1. Boesecke C, Rockstroh JK. Acute hepatitis C in patients with HIV. Semin Liver Dis 2012; 32:130–7. - PubMed
    1. van Santen DK, van der Helm JJ, Del Amo J et al. . Lack of decline in hepatitis C virus incidence among HIV-positive men who have sex with men during 1990–2014. J Hepatol 2017; 67:255–62. - PubMed
    1. Vanhommerig JW, Lambers FA, Schinkel J et al. . Risk factors for sexual transmission of hepatitis C virus among human immunodeficiency virus-infected men who have sex with men: a case-control study. Open Forum Infect Dis 2015; 2:ofv115. - PMC - PubMed