WHO targets for Hepatitis C treatment in people living with HIV not achieved in European region
In 2016, The World Health Organisation (WHO) set ambitious targets of diagnosing 90% of people living with HIV and treating 80% of those who received a diagnosis, they also recommended that people co-infected with Hepatitis C and HIV be prioritised for treatment.
These targets were made all the more achievable by the advent of Direct Acting Antiviral (DAA) treatments, such as sofosbuvir, which have a high cure rate and are far more tolerated than previous treatment types.
Dr Olga Fursa, of the Rigshospitalet Copenhagen, worked with colleagues to assess Europe’s progress towards the goals of diagnosing, treating and curing Hepatitis C in people living with HIV. The study was published in AIDS journal.
Records covering 4,773 people, taking from the EuroSIDA cohort, were used for the analysis. Those included in the data set had to have Hepatitis C antibodies or evidence of a Hepatitis C co-infection, as well as being in follow up at the end of 2019. 70% were male, 57% had acquired HIV through injecting drug use, 20% were men who have sex with men, and the median age was 51 years.
Researchers split the records in to five European regions to allow for comparison:
- South: Greece, Israel, Italy, Portugal and Spain.
- Central-West: Austria, Belgium, France, Germany, Luxembourg and Switzerland.
- North: Denmark, Finland, Iceland, Ireland, the Netherlands, Norway, Sweden and the UK.
- Central-East: Bosnia-Herzegovina, Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia and Slovenia.
- East: Belarus, Estonia, Georgia, Latvia, Lithuania, Russia and Ukraine.
Across all regions 93% of participants had been tested for Hepatitis C at least once, and 19% were RNA positive at time of analysis - this was higher in Eastern and Central-Eastern regions at 34% and 30% respectively.
Of those who had been diagnosed with Hepatitis C (4,300) 73% started treatment, 71% completed treatment, 63% had follow-up, and 56% were cured of their Hepatitis C infection.
When it came to starting treatment the highest proportion was seen in Central-Western Europe at 85% and the lowest was in Eastern Europe at 48%, with cure rates as low as 28% in the Eastern Europe region and only 11% in Belarus.
The study’s authors conclude by saying that whilst all regions, apart from Eastern Europe, achieved or exceeded the WHO target of diagnosing 90% of chronic Hepatitis C infections, none of the five regions achieved the target of treating 80% of people living with a HIV and Hepatitis C co-infection.
