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. 2022 Aug;23(7):705-716.
doi: 10.1111/hiv.13229. Epub 2022 Jan 17.

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Chiara Fanciulli  1   2 , Juan Berenguer #  1   2 , Carmen Busca  2   3 , María J Vivancos  2   4 , María J Téllez  2   5 , Lourdes Domínguez  2   6 , Pere Domingo  7 , Jordi Navarro  2   8 , Jesús Santos  9 , José A Iribarren  10 , Luis Morano  11 , Arturo Artero  12 , Javier Moreno  13 , Antonio Rivero-Román  2   14 , Ignacio Santos  2   15 , Livia Giner  16 , Carlos Armiñanzas  2   17 , Marta Montero  18 , Christian Manzardo  19   20 , Carmen Cifuentes  21 , Coral García  22 , María J Galindo  23 , Oscar L Ferrero  24 , José Sanz  25 , Belén de la Fuente  26 , Carmen Rodríguez  27 , Gabriel Gaspar  28 , Laura Pérez  29 , Juan E Losa  30 , Luis Force  31 , Sergio Veloso  32 , Elisa Martínez-Alfaro  33 , Inmaculada Jarrín  2   34 , Marta De Miguel  35 , Juan González Garcia #  2   3 ; GeSIDA 8514 Study Group
Collaborators, Affiliations

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Chiara Fanciulli et al. HIV Med. 2022 Aug.

Abstract

Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018.

Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation.

Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001).

Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population.

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

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Conflict of interest statement

JB reports honoraria for advice or public speaking from AbbVie, Gilead, MSD, Janssen and ViiV Healthcare; and grants from AbbVie, Gilead, MSD and ViiV Healthcare. AR‐R reports honoraria for advice or public speaking from AbbVie, Gilead, MSD, Janssen and ViiV Healthcare, and grants from AbbVie, Gilead, MSD, Janssen and ViiV Healthcare. IJ reports honoraria for advice or public speaking from Gilead and ViiV Healthcare. JGG reports honoraria for advice or public speaking from AbbVie, Gilead, MSD, Janssen and ViiV Healthcare, and grants from Gilead, MSD and ViiV Healthcare. The rest of the authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Prevalence of hepatitis C virus (HCV) seropositivity and active HCV infection in the annual cross‐sectional studies carried out by ‘Grupo de Estudio del SIDA’ (GeSIDA) from 2015 to 2019. HCV Ab+, presence of antibodies against HCV; HCV‐RNA+, detectable HCV‐RNA
FIGURE 2
FIGURE 2
Prevalence of hepatitis C virus (HCV) seropositivity and active HCV infection in the annual cross‐sectional studies carried out by ‘Grupo de Estudio del SIDA’ (GeSIDA) from 2015 to 2019, categorized by HIV transmission category groups. HCV Ab+, presence of antibodies against HCV; HCV‐RNA+, detectable HCV‐RNA, IDU, injection drug use; MSM, men who have sex with men
FIGURE 3
FIGURE 3
Uptake of anti‐hepatitis C virus (HCV) treatment in the annual cross‐sectional studies carried out by the ‘Grupo de Estudio del SIDA’ (GeSIDA) from 2015 to 2019. Treatment uptake was defined as the proportion of people living with HIV with current or past chronic HCV infection exposed to anti‐HCV therapy
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