HIV-丙型肝炎合并感染患者直接抗病毒治疗的比较结果：来自哥伦比亚一个中心经验的见解
Comparative outcomes of direct-acting antiviral treatment in patients with HIV-Hepatitis C co-infection: insights from a single center experience in Colombia.
作者信息
Vergara-Samur Hernán, Martínez-Vernaza Samuel, De la Hoz Alejandro, Barahona-Correa Julián, Ortiz Juan Pablo, Gualtero-Trujillo Sandra, Rumbo-Romero José, Salazar Luis Miguel, Suárez Quintero Yanette, Valderrama-Beltrán Sandra
机构信息
Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia.
Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia.
出版信息
Infez Med. 2023 Sep 1;31(3):374-383. doi: 10.53854/liim-3103-11. eCollection 2023.
BACKGROUND
Direct-acting antivirals (DAA) were introduced to Latin America with the aim of eliminating hepatitis C (HCV) in the region. There are scarce data on the outcomes of people living with HIV and HCV treated with these medications in Colombia. This study compares the outcomes of patients with HIV-HCV co-infection and HCV mono-infection treated with DAAs.
METHODS
Retrospective observational study including patients ≥18 years old with HCV infection treated with DAAs from August 2017 to December 2019 in a comprehensive center in Colombia. The main outcome was sustained virologic response (SVR). Secondary outcomes included reinfection, relapse and adverse events.
RESULTS
We included 223 individuals with HCV treated with DAAs; 142 (63.6%) individuals were mono-infected and 81 (36.3%) co-infected. Genotypes 1b (49.7%) and 4 (33.9%) were the most common. Overall SVR after DAA treatment was 96.8%. Relapse rate was 2.24%, reinfection rate was 6.28% and adverse events occurred in 27.8% of cases. SVR was comparable in patients with co- and mono-infection (95% vs 97.8%, p=0.245).
CONCLUSION
DAA were effective in mono-infected (HCV) and co-infected (HCV/HIV) patients and reinfection was high in this last group.
背景
直接作用抗病毒药物（DAA）被引入拉丁美洲，旨在消除该地区的丙型肝炎（HCV）。在哥伦比亚，关于接受这些药物治疗的艾滋病毒和HCV感染者的治疗结果的数据很少。本研究比较了接受DAA治疗的HIV-HCV合并感染患者和HCV单一感染患者的治疗结果。
方法
回顾性观察研究，纳入2017年8月至2019年12月在哥伦比亚一家综合中心接受DAA治疗的≥18岁HCV感染患者。主要结局是持续病毒学应答（SVR）。次要结局包括再感染、复发和不良事件。
结果
我们纳入了223例接受DAA治疗的HCV患者；142例（63.6%）为单一感染，81例（36.3%）为合并感染。1b型（49.7%）和4型（33.9%）是最常见的基因型。DAA治疗后的总体SVR为96.8%。复发率为2.24%，再感染率为6.28%，27.8%的病例发生了不良事件。合并感染和单一感染患者的SVR相当（95%对97.8%，p=0.245）。
结论
DAA对单一感染（HCV）和合并感染（HCV/HIV）患者有效，后一组的再感染率很高。
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