Predictors of hepatitis C treatment failure after using direct-acting antivirals in people living with human immunodeficiency virus
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Predictors of hepatitis C treatment failure after using direct-acting antivirals in people living with human immunodeficiency virusAuthor(s)
Date
2019-02-11Citation
Cachay ER, Mena Á, Morano L, Benitez L, Maida I, Ballard C, et al. Predictors of hepatitis C treatment failure after using direct-acting antivirals in people living with human immunodeficiency virus. Open Forum Infect Dis. 2019;6(3):ofz070
Abstract
[Abstract] Background. Little is known about the influence of ongoing barriers to care in the persistence of hepatitis C virus (HCV) viremia after treatment with direct-acting antivirals (DAAs) among people living with human immunodeficiency virus (PLWH).
Methods. We conducted a retrospective cohort analysis of PLWH treated through the standard of care in 3 Western countries, to investigate the predictors of HCV treatment failure (clinical or virologic), defined as having a detectable serum HCV ribonucleic acid within 12 weeks after DAA discontinuation. In addition to HCV and liver-related predictors, we collected data on ongoing illicit drug use, alcohol abuse, mental illness, and unstable housing. Logistic regression analyses were used to identify predictors of HCV treatment failure.
Results. Between January 2014 and December 2017, 784 PLWH were treated with DAA, 7% (n = 55) of whom failed HCV therapy: 50.9% (n = 28) had a clinical failure (discontinued DAA therapy prematurely, died, or were lost to follow-up), 47.3% (n = 26) had an HCV virologic failure, and 1 (1.8%) was reinfected with HCV. Ongoing drug use (odds ratio [OR] = 2.60) and mental illness (OR = 2.85) were independent predictors of any HCV treatment failure. Having both present explained 20% of the risk of any HCV treatment failure due to their interaction (OR = 7.47; P < .0001). Predictors of HCV virologic failure were ongoing illicit drug use (OR = 2.75) and advanced liver fibrosis (OR = 2.29).
Conclusions. People living with human immunodeficiency virus with ongoing illicit drug use, mental illness, and advanced liver fibrosis might benefit from enhanced DAA treatment strategies to reduce the risk of HCV treatment failure.
Keywords
DAA
Drug use
HCV treatment failure
HIV
Mental illness
Drug use
HCV treatment failure
HIV
Mental illness
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Atribución-NoComercial-SinDerivadas 3.0 España
ISSN
2328-8957