Estimated uptake of hepatitis C direct-acting antiviral treatment among individuals with HIV co-infection in Australia: a retrospective cohort study
Nima Iranpour
A , Gregory J. Dore A , Marianne Martinello A , Gail V. Matthews A , Jason Grebely A and Behzad Hajarizadeh A B
A The Kirby Institute, Wallace Wurth Building, UNSW Sydney, NSW 2051, Australia.
B Corresponding author. Email: bhajarizadeh@kirby.unsw.edu.au
Sexual Health 17(3) 223-230 https://doi.org/10.1071/SH19101
Submitted: 12 September 2019 Accepted: 20 December 2019 Published: 30 March 2020
Abstract
Background: Unrestricted access to direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has been available in Australia since March 2016. Individuals with HIV–HCV co-infection are at a greater risk of liver fibrosis progression. This study estimated DAA treatment uptake among individuals with HIV–HCV co-infection, during the first year of DAA treatment access in Australia. Methods: Pharmaceutical Benefits Scheme (PBS) data on dispensed DAA and antiretroviral therapy (ART) prescriptions from March 2016 to March 2017 were used for analysis. Results: During March 2016 to March 2017, a total of 935 individuals with HIV–HCV co-infection were receiving ART and initiated DAA treatment, with 93% to 97% completing their prescribed course. Estimated DAA treatment uptake in the HIV–HCV-infected population was 41% (935/2290). Most were men (94%). Median age was 50 years. DAA treatment was initiated by specialists in 64% of cases (n = 602), and by general practitioners (GPs) in 25% of cases (n = 238). The proportion of individuals initiated on DAA by GPs increased from 20% in March–April 2016 to 26% in January–March 2017. Most specialists (77%) and GPs (72%) initiated DAA treatment for one to three patients. Among individuals initiated on DAA by GPs, 68% received their ART prescription from the same GP. Conclusions: A high level of DAA treatment uptake and completion was observed among individuals with HIV–HCV co-infection during the first year of DAA treatment access. The proportion of individuals prescribed DAA by GPs increased over time; this is important for broadened access.
Additional keywords: hepatitis C virus, human immunodeficiency virus, interferon-free, treatment uptake.
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