The current gold standard for treatment of chronic hepatitis C virus (HCV) infection is direct-acting antiviral (DAA) therapy, which has proven to be safe and highly efficacious. However, DAA therapy is quite costly and this limitation has led to its use being restricted in many countries.
In the Netherlands, DAA regimens became available initially for patients with severe liver fibrosis as well as patients coinfected with HIV. In a study published by the Oxford University Press, lead co-investigators, Anne Boerekamps, PhD, and Astrid Newsum along with their colleagues examined HCV treatment uptake in HCV and HIV coinfected patients in the Netherlands.
The study utilized the AIDS Therapy Evaluation in the Netherlands (ATHENA) database which includes information on more than 98% of the HIV-positive patients in care in the Netherlands. There are 26 designated treatment centers in the Netherlands which provide care for HIV patients. The ATHENA cohort is responsible for collecting demographic and treatment data as well as data on patients coinfected with HIV and viral hepatitis. Out of the 23,574 HIV patients registered in the ATHENA cohort as of the February 1, 2017, 2503 patients had at least one positive HCV RNA test. The authors excluded patients who spontaneously cleared their HCV infection as well as patients who died or were lost to follow-up, resulting in 1471 patients who were coinfected with HIV and HCV. Ninety-percent of the patients included in the study were male and the most commonly reported route of HIV transmission was MSM (69%). In addition, HIV transmission occurred for the remaining 15% either through drug use or other routes.