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Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals—Results from the EuroSIDA study

Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals—Results from the EuroSIDA study


Title: Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals—Results from the EuroSIDA study
Author: for the EuroSIDA study group
Date: 2022-08-08
Language: English
Scope:
Department: Faculty of Medicine
Other departments
Series: HIV Medicine; ()
ISSN: 1464-2662
DOI: https://doi.org/10.1111/hiv.13357
Subject: Smitsjúkdómalæknisfræði; co-infection; contraindications; DAA; HCV; HIV; Health Policy; Infectious Diseases; Pharmacology (medical)
URI: https://hdl.handle.net/20.500.11815/3856

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Citation:

for the EuroSIDA study group 2022 , ' Use of contraindicated antiretroviral drugs in people with HIV/HCV coinfections receiving HCV treatment with direct-acting antivirals—Results from the EuroSIDA study ' , HIV Medicine . https://doi.org/10.1111/hiv.13357

Abstract:

Objectives: Our objective was to determine whether antiretroviral drugs (ARVs) were used according to the European AIDS Clinical Society (EACS) guidelines for people with HIV/hepatitis C virus (HCV) coinfection treated with direct-acting antivirals (DAAs) between 30 November 2014 and 31 December 2019 in the pan-European EuroSIDA study. Methods: At each publication date of the EACS guidelines, plus 3 and 6 months, we calculated the number of people receiving DAAs with potential and actual ARV contraindications (‘red shading’ in the EACS guidelines). We used logistic regression to investigate factors associated with using contraindicated ARVs. Results: Among 1406 people starting DAAs, the median age was 51 years, 75% were male, 57% reported injected drug use as an HIV risk, and 76% were from western Europe. Of 1624 treatment episodes, 609 (37.5%) occurred while the patient was receiving ARVs with potential contraindications; among them, 38 (6.2%; 95% confidence interval [CI] 4.3–8.2) involved a contraindicated ARV (18 non-nucleoside reverse transcriptase inhibitors), 16 involved protease inhibitors, and four involved integrase strand transfer inhibitors. The adjusted odds of receiving a contraindicated ARV were higher (3.25; 95% CI 1.40–7.57) among participants from east/central east Europe (vs. south) and lower (0.22; 95% CI 0.08–0.65) for 2015–2018 guidelines (vs. 2014). In total, 29 of the 32 (90.6%) patients receiving a contraindicated ARV and 441 of the 461 (95.7%) with potential ARV contraindications experienced a sustained virological response ≥12 weeks after stopping treatment (SVR12; p = 0.55). Conclusion: In this large heterogenous European cohort, more than one-third of people with HIV/HCV coinfection received DAAs with potential ARV contraindications, but few received a contraindicated ARV. Use of contraindicated ARVs declined over time, corresponding to the increased availability of ARV therapy regimens without interactions with DAA across Europe. Participants who received a contraindicated DAA and ARV combination still had a high rate of SVR12.

Description:

Funding Information: AM has received travel support, honoraria, and/or consultancy fees from ViiV, Gilead, and Eiland & Bonnin outside the submitted work. GW has received research grants from Gilead Sciences and Roche Diagnostics and honoraria from Gilead, MSD, and ViiV outside the submitted work and all paid to his institution. TB has received grants from Novo Nordisk Foundation, Simonsen Foundation, Lundbeck Foundation, Kai Hansen Foundation, and Erik and Susanna Olesen's Charitable Fund; grants and personal fees from GSK, Pfizer, and Gilead; and personal fees from Boehringer Ingelheim, MSD, and Pentabase ApS, outside the submitted work. All other co‐authors reported no conflicts of interest. Publisher Copyright: © 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

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