BACKGROUND Although several studies analyzing the effectiveness of DAAs have showed no differences between HCV-monoinfected and HIV/HCV-coinfected patients,data in real-life setting are still limited. PURPOSE To compare efficacy and costs of DAAs in HCV-monoinfected and HIV/HCV-coinfected subjects. METHODS A database of HCV-monoinfected and HIV/HCV-coinfected adults who started HCV therapy between January 2015 and July 2016 was created in order to collect the following data:sustained virological response to DAAs therapy at week 12(SVR12) and at week 24(SVR24) after treatment initiation, treatment regimen, and overall cost of anti-HCV regimens.Patients were treated as follows: sofosbuvir/ribavirin ± peg-INF (n=37), sofosbuvir/daclatasvir(n=72), sofosburiv/ledipasvir(n=68), sofosburiv/simeprevir(n=77), simeprevir/peg-interferon(n=13) or ombitasvir/paritaprevir/ritonavir/dasabuvir(n=14). Overall, ribavirin was used in combination with DAAs in 67% of patients. RESULTS The study enrolled 281 subjects(81% monoinfected and 19% co-infected), treated for 12(54% of monoinfected and 50% of co-infected) or 24 weeks(46% of monoinfected and 50% of co-infected). Two hundred and twenty nine patients had cirrhosis or high degree fibrosis (≥F3) at the beginning of DAAs (79% of HCV-monoinfected and 91% of HIV/HCV co-infected);other 23 subjects(all but one HCV-monoinfected) were treated after liver transplantation. Two hundreds and ten (93%) HCV-monoinfected patients completed the treatment; 96% achieved SVR12 and 97% reached SVR24. The most prescribed regimens were 12-week sofosburiv/simeprevir(27%) or sofosburiv/ledipasvir(17%), and 24-week sofosbuvir/daclatasvir(17%). The average cost of a complete HCV-treatment in monoinfected population was € 49.633 per patient. Among the 47 HIV/HCV-coinfected patients(87%) who completed the treatment, 94% achieved SVR12 and 96% obtained SVR24;12-week sofosburiv/simeprevir was prescribed to 24% of them, whereas the most frequent 24-week treatments were sofosburiv/daclatasvir and sofosburiv/ledipasvir(20% each). The average cost of a complete HCV-treatment in coinfected population was € 53.573 per patient. CONCLUSION This study confirms the high effectiveness of DAAs in the treatment of HCV infection in real life setting, both in HCV-monoinfected and HIV/HCV-coinfected patients. The average cost of single treatment was also similar between the two groups.

Efficacy and costs of Direct Acting Antivirals (DAAS) for the treatment of HCV Iinfection amnog HCV-monoinfected and HIV/HCV co-infected patients in real-life setting

CASTELLETTI, SEFORA;COSTANTINI, ANDREA
2017-01-01

Abstract

BACKGROUND Although several studies analyzing the effectiveness of DAAs have showed no differences between HCV-monoinfected and HIV/HCV-coinfected patients,data in real-life setting are still limited. PURPOSE To compare efficacy and costs of DAAs in HCV-monoinfected and HIV/HCV-coinfected subjects. METHODS A database of HCV-monoinfected and HIV/HCV-coinfected adults who started HCV therapy between January 2015 and July 2016 was created in order to collect the following data:sustained virological response to DAAs therapy at week 12(SVR12) and at week 24(SVR24) after treatment initiation, treatment regimen, and overall cost of anti-HCV regimens.Patients were treated as follows: sofosbuvir/ribavirin ± peg-INF (n=37), sofosbuvir/daclatasvir(n=72), sofosburiv/ledipasvir(n=68), sofosburiv/simeprevir(n=77), simeprevir/peg-interferon(n=13) or ombitasvir/paritaprevir/ritonavir/dasabuvir(n=14). Overall, ribavirin was used in combination with DAAs in 67% of patients. RESULTS The study enrolled 281 subjects(81% monoinfected and 19% co-infected), treated for 12(54% of monoinfected and 50% of co-infected) or 24 weeks(46% of monoinfected and 50% of co-infected). Two hundred and twenty nine patients had cirrhosis or high degree fibrosis (≥F3) at the beginning of DAAs (79% of HCV-monoinfected and 91% of HIV/HCV co-infected);other 23 subjects(all but one HCV-monoinfected) were treated after liver transplantation. Two hundreds and ten (93%) HCV-monoinfected patients completed the treatment; 96% achieved SVR12 and 97% reached SVR24. The most prescribed regimens were 12-week sofosburiv/simeprevir(27%) or sofosburiv/ledipasvir(17%), and 24-week sofosbuvir/daclatasvir(17%). The average cost of a complete HCV-treatment in monoinfected population was € 49.633 per patient. Among the 47 HIV/HCV-coinfected patients(87%) who completed the treatment, 94% achieved SVR12 and 96% obtained SVR24;12-week sofosburiv/simeprevir was prescribed to 24% of them, whereas the most frequent 24-week treatments were sofosburiv/daclatasvir and sofosburiv/ledipasvir(20% each). The average cost of a complete HCV-treatment in coinfected population was € 53.573 per patient. CONCLUSION This study confirms the high effectiveness of DAAs in the treatment of HCV infection in real life setting, both in HCV-monoinfected and HIV/HCV-coinfected patients. The average cost of single treatment was also similar between the two groups.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/248695
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