THE ISSUE:

Encouraging new Hepatitis C treatments are now available that increase success rates to up to 70%. New treatments are important for those living with HCV and HIV since these infections increase the risk of developing end stage liver disease, one of the leading causes of death in this population.

However, not all patients living with HIV and HCV are eligible for these new treatments. It is important to identify challenges such as depression, alcohol abuse and drug-drug interactions for the greatest number of patients to benefit from these new treatments.

 

THE RESEARCH:

The Canadian Co-infection Cohort study is a research project involving people living with HIV and HCV in Canada. As of October 2011, the study included 1020 participants from 16 health care centers across Canada.

 

THE FINDINGS:

  • Of the 1020 participants in the study, 707 were currently infected with HCV and required treatment
  • Many patients had contraindications to treatment, meaning the new treatments would not be prescribed since it may not work or may be harmful to the patient
  • Contraindications to new treatments included alcohol abuse, active depression and advanced liver disease
  • Out of 707 patients, only 182 were eligible for the new treatment. Of these, 39 previously had other HCVtreatment but did not clear the infection
  • Only 143 patients (38%) have never received treatment and could benefit from new HCV treatments

 

CONCLUSION:

This study shows that despite our optimism, few patients would be able to benefit from new HCV treatments.

 

MOVING FORWARD:

Strategies to increase the number of patients eligible for new treatments include:

  • Addressing alcohol abuse and active depression
  • Changing HIV medications when needed
  • Increasing access to teams of care providers to support HCV treatment adherence

Publication:

Klein MB et al. Who needs direct acting antivirals for Hepatitis C virus (HCV)? Challenges faced in advancing HCV therapy for HIV–HCV co-infected persons, Antiviral Therapy, 2012.

Link to full publication:
http://www.ncbi.nlm.nih.gov/pubmed/23211632