Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - “En route for eradication”?

- The Dat'AIDS cohort covers about 25% of HIV-infected patients in France.
- DAA are highly effective in a real world cohort of HIV-HCV coinfected patients.
- In 2015, HCV treatment initiation rate was 29% in HIV-HCV patients in France.
- By the end of 2015, 63% of patients were cured either spontaneously or following SVR.

SummaryObjectivesDirect-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients.MethodsAll HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection.ResultsAmong 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR.ConclusionsHCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.