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. 2023 Jun 28;18(6):e0287909.
doi: 10.1371/journal.pone.0287909. eCollection 2023.

Trends in hepatitis C virus coinfection and its cascade of care among adults living with HIV in Asia between 2010 and 2020

Jeremy Ross  1 , Dhanushi Rupasinghe  2 , Anchalee Avihingsanon  3 , Man Po Lee  4 , Sanjay Pujari  5 , Gerald Sharp  6 , Nagalingeswaran Kumarasamy  7 , Suwimon Khusuwan  8 , Vohith Khol  9 , I Ketut Agus Somia  10 , Thach Ngoc Pham  11 , Sasisopin Kiertiburanakul  12 , Jun Yong Choi  13 , Cuong Duy Do  14 , Annette H Sohn  1 , Awachana Jiamsakul  2 ; TAHOD-LITE study group of IeDEA Asia‐Pacific
Affiliations

Trends in hepatitis C virus coinfection and its cascade of care among adults living with HIV in Asia between 2010 and 2020

Jeremy Ross et al. PLoS One. .

Abstract

Background: Chronic hepatitis C virus (HCV) infection contributes to substantial morbidity and mortality among adults living with HIV. Cascades of HCV care support monitoring of program performance, but data from Asia are limited. We assessed regional HCV coinfection and cascade outcomes among adults living with HIV in care from 2010-2020.

Methods: Patients ≥18 years old with confirmed HIV infection on antiretroviral therapy (ART) at 11 clinical sites in Cambodia, China, India, Indonesia, South Korea, Thailand and Vietnam were included. HCV- and HIV-related treatment and laboratory data were collected from those with a positive HCV antibody (anti-HCV) test after January 2010. An HCV cascade was evaluated, including proportions positive for anti-HCV, tested for HCV RNA or HCV core antigen (HCVcAg), initiated on HCV treatment, and achieved sustained virologic response (SVR). Factors associated with screening uptake, treatment initiation, and treatment response were analyzed using Fine and Gray's competing risk regression model.

Results: Of 24,421 patients, 9169 (38%) had an anti-HCV test, and 971 (11%) had a positive result. The proportion with positive anti-HCV was 12.1% in 2010-2014, 3.9% in 2015-2017, and 3.8% in 2018-2020. From 2010 to 2014, 34% with positive anti-HCV had subsequent HCV RNA or HCVcAg testing, 66% initiated HCV treatment, and 83% achieved SVR. From 2015 to 2017, 69% with positive anti-HCV had subsequent HCV RNA or HCVcAg testing, 59% initiated HCV treatment, and 88% achieved SVR. From 2018 to 2020, 80% had subsequent HCV RNA or HCVcAg testing, 61% initiated HCV treatment, and 96% achieved SVR. Having chronic HCV in later calendar years and in high-income countries were associated with increased screening, treatment initiation or achieving SVR. Older age, injecting drug use HIV exposure, lower CD4 and higher HIV RNA were associated with reduced HCV screening or treatment initiation.

Conclusions: Our analysis identified persistent gaps in the HCV cascade of care, highlighting the need for focused efforts to strengthen chronic HCV screening, treatment initiation, and monitoring among adult PLHIV in the Asia region.

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Conflict of interest statement

AHS has received grants to her institution from ViiV Healthcare and Gilead Sciences. Other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Proportion anti-HCV positive among those screened for HCV in year groups from 2010 to 2020.
Fig 2
Fig 2. Hepatitis C cascade for those with positive anti-HCV in year groups from 2010 to 2020.
(A) 2010 to 2014 (B) 2015 to 2017 (C) 2018 to 2020.
Fig 3
Fig 3. Probability of not initiating HCV treatment after positive anti-HCV.
See this image and copyright information in PMC

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