Amele, Sarah;
(2021)
The impact of DAA treatment on HIV/HCV co-infected individuals across Europe: Analyses of co-infection data from a European cohort study.
Doctoral thesis (Ph.D), UCL (University College London).
Preview |
Text
Amele__thesis_edited version.pdf Download (11MB) | Preview |
Abstract
With the introduction of safe and highly efficacious direct-acting antivirals (DAAs), elimination of HCV has become more viable. The World Health Organisation set the targets of reducing HCV incidence and mortality by 2030 to achieve this goal. To meet these goals, increased consideration is required of those most at risk of HCV, such as people living with HIV (PLWH) due to the shared routes of transmission. Data from the EuroSIDA study has been used to investigate the epidemiological characteristics of HIV/HCV co-infected individuals in Europe, with a specific focus on regional differences in DAA effectiveness and treatment outcomes. My findings show that there were major gaps at all stages of the HCV continuum of care among PLWH for all regions in 2015, with only 78% of anti-HCV positive individuals receiving a HCV-RNA test, 47% of those HCV-RNA positive starting HCV treatment and 23% achieving SVR. By 2017 there were improvements in the transition of individuals through stages after improved access to DAAs, as 83% of individuals who were anti-HCV positive were HCV-RNA tested, 61% of those HCV-RNA positive received treatment, and 42% achieved SVR. Among individuals treated with DAAs who had a known treatment response, 91.5% achieved SVR12. There was no evidence of regional differences, indicating high rates of SVR12 can be achieved across all European regions in real-world settings. The proportion of individuals who were reinfected within 24 months of achieving SVR was 7.7% among HIV/HCV co-infected individuals, with evidence of regional differences. There was also evidence to suggest that the odds of individuals being reinfected decreased over time. The findings from these studies highlight the effectiveness of DAAs and their positive impact on the outcomes of HIV/HCV co-infected individuals. However, to achieve the goal of HCV elimination by 2030, improvements in HCV screening and access to DAAs is urgently required.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | The impact of DAA treatment on HIV/HCV co-infected individuals across Europe: Analyses of co-infection data from a European cohort study |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10138803 |
Archive Staff Only
 |
View Item |
