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Fanciulli C, Berenguer J, Busca C, Vivancos MJ, Téllez MJ, Domínguez L, Domingo P, Navarro J, Santos J, Iribarren JA, Morano L, Artero A, Moreno J, Rivero-Román A, Santos I, Giner L, Armiñanzas C, Montero M, Manzardo C, Cifuentes C, García C, Galindo MJ, Ferrero OL, Sanz J, de la Fuente B, Rodríguez C, Gaspar G, Pérez L, Losa JE, Force L, Veloso S, Martínez-Alfaro E, Jarrín I, De Miguel M, González Garcia J. Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019. HIV Med 2022; 23:705-716. [PMID: 35037379 PMCID: PMC9543728 DOI: 10.1111/hiv.13229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 01/03/2023]
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.
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Affiliation(s)
- Chiara Fanciulli
- Infectious Diseases and Clinical Microbiology, Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERINFEC, Madrid, Spain
| | - Juan Berenguer
- Infectious Diseases and Clinical Microbiology, Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERINFEC, Madrid, Spain
| | - Carmen Busca
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - María J Vivancos
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Ramón y Cajal (Irycis), Madrid, Spain
| | - María J Téllez
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Clínico San Carlos, Madrid, Spain
| | - Lourdes Domínguez
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pere Domingo
- Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jordi Navarro
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitari Vall d´Hebrón, Barcelona, Spain
| | - Jesús Santos
- Infectious Diseases, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Luis Morano
- Infectious Diseases, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Arturo Artero
- Internal Medicine and Infectious Diseases, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Javier Moreno
- Infectious Diseases, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Antonio Rivero-Román
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ignacio Santos
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario de la Princesa, Madrid, Spain
| | - Livia Giner
- Infectious Diseases, Hospital General Universitario de Alicante, Alicante, Spain
| | - Carlos Armiñanzas
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Marta Montero
- Infectious Diseases, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Christian Manzardo
- Infectious Diseases, Hospital Arnau de Vilanova, Lleida, Spain.,Infectious Diseases, Hospital Santa María, Lleida, Spain
| | - Carmen Cifuentes
- Infectious Diseases, Hospital Son Llàtzer, Palma de Mallorca, Mallorca, Spain
| | - Coral García
- Infectious Diseases, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María J Galindo
- Internal Medicine and Infectious Diseases, Hospital Clínico de Valencia, Valencia, Spain
| | - Oscar L Ferrero
- Infectious Diseases, Hospital Universitario de Basurto, Bilbao, Spain
| | - José Sanz
- Infectious Diseases, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | | | | | - Gabriel Gaspar
- Internal Medicine and Infectious Diseases, Hospital Universitario de Getafe, Getafe, Spain
| | - Laura Pérez
- Infectious Diseases, Hospital San Pedro, Logroño, Spain
| | - Juan E Losa
- Infectious Diseases, Fundación Hospital Alcorcón, Alcorcón, Spain
| | - Luis Force
- Internal Medicine and Infectious Diseases, Hospital de Mataró, Mataró, Spain
| | - Sergio Veloso
- Infectious Diseases, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Elisa Martínez-Alfaro
- Infectious Diseases, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Inmaculada Jarrín
- CIBERINFEC, Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Juan González Garcia
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
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Berenguer J, Jarrín I, Pérez-Latorre L, Hontañón V, Vivancos MJ, Navarro J, Téllez MJ, Guardiola JM, Iribarren JA, Rivero-Juárez A, Márquez M, Artero A, Morano L, Santos I, Moreno J, Fariñas MC, Galindo MJ, Hernando MA, Montero M, Cifuentes C, Domingo P, Sanz J, Domíngez L, Ferrero OL, De la Fuente B, Rodríguez C, Reus S, Hernández-Quero J, Gaspar G, Pérez-Martínez L, García C, Force L, Veloso S, Losa JE, Vilaró J, Bernal E, Arponen S, Ortí AJ, Chocarro Á, Teira R, Alonso G, Silvariño R, Vegas A, Geijo P, Bisbe J, Esteban H, González-García J. Human Immunodeficiency Virus/Hepatits C Virus Coinfection in Spain: Elimination Is Feasible, but the Burden of Residual Cirrhosis Will Be Significant. Open Forum Infect Dis 2018; 5:ofx258. [PMID: 29354658 PMCID: PMC5767960 DOI: 10.1093/ofid/ofx258] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/19/2017] [Indexed: 12/13/2022] Open
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.
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Affiliation(s)
- Juan Berenguer
- Hospital General Universitario Gregorio Marañón/Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Leire Pérez-Latorre
- Hospital General Universitario Gregorio Marañón/Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Víctor Hontañón
- Hospital Universitario La Paz/Instituto de Investigación Sanitaria La Paz, Madrid, Spain
| | | | | | | | | | | | - Antonio Rivero-Juárez
- Hospital Universitario Reina Sofia/Instituto Maimónides de Investigación Biomédica de Córdoba, Spain
| | | | | | - Luis Morano
- Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | | | | | - María C Fariñas
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - María A Hernando
- Universidad Europea/Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Pere Domingo
- Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - José Sanz
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Lourdes Domíngez
- Hospital Universitario 12 de Octubre/ Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sari Arponen
- Hospital Universitario de Torrejón, Torrejón de Ardoz, Spain
| | | | | | | | | | | | - Ana Vegas
- Hospital Infanta Elena, Valdemoro, Spain
| | | | | | | | - Juan González-García
- Hospital Universitario La Paz/Instituto de Investigación Sanitaria La Paz, Madrid, Spain
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