Abstract
Original language | English |
---|---|
Journal | HIV medicine |
Early online date | 2021 |
DOIs | |
Publication status | E-pub ahead of print - 2021 |
Keywords
- HCV
- HIV
- direct-acting antivirals
- interferon
- reinfection
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In: HIV medicine, 2021.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - HCV reinfection after HCV therapy among HIV/HCV-coinfected individuals in Europe
AU - Amele, Sarah
AU - Sandri, Anastasia Karachalia
AU - Rodger, Alison
AU - Vandekerckhove, Linos
AU - Benfield, Thomas
AU - Milinkovic, Ana
AU - Duvivier, Claudine
AU - Stellbrink, Hans-J. rgen
AU - Sambatakou, Helen
AU - Chkhartishvili, Nikoloz
AU - Caldeira, Luis
AU - Laguno, Monserrat
AU - Domingo, Pere
AU - Wandeler, Gilles
AU - Gisinger, Martin
AU - Kuzovatova, Elena
AU - Dragovic, Gordana
AU - Knysz, Brygida
AU - Matulionyte, Raimonda
AU - Rockstroh, J. rgen Kurt
AU - Lundgren, Jens Dilling
AU - Mocroft, Amanda
AU - Peters, Lars
AU - the EuroSIDA study group
AU - Harxhi, A.
AU - Losso, M.
AU - Kundro, M.
AU - Schmied, B.
AU - Zangerle, R.
AU - Karpov, I.
AU - Vassilenko, A.
AU - Mitsura, V. M.
AU - Paduto, D.
AU - Clumeck, N.
AU - Wit, S. De
AU - Delforge, M.
AU - Florence, E.
AU - Vandekerckhove, L.
AU - Hadziosmanovic, V.
AU - Begovac, J.
AU - Machala, L.
AU - Jilich, D.
AU - Sedlacek, D.
AU - Kronborg, G.
AU - Benfield, T.
AU - Gerstoft, J.
AU - Katzenstein, T.
AU - Pedersen, C.
AU - Johansen, I. S.
AU - Ostergaard, L.
AU - Reiss, P.
N1 - Funding Information: 【Abstract】 Objective To understand the current status of community health management, treatment and control of hypertension in patients aged 35 years and above in China in 2015, and identify the influencing factors. Methods Using the questionnaire survey results and physical measurement information collected by China Chronic Diseases and Nutrition Monitoring System in 2015, hypertension patients aged 35 years and above diagnosed at township health center level (community health service centers) or above were selected as the research subjects. The patients were complexly weighted to analyze their general characteristics, community health management, treatment and control status. Results This study included 23 974 hypertension patients aged 35 years and above diagnosed by medical and health institutions at township level and above in 2015. After complex weighting, the community health management rate of hypertension patients aged 35 years and above was 54.10% (95%CI: 51.02%-57.17%), the standardized community management rate was 45.72% (95%CI: 42.93%-48.51%), the treatment rate was 88.16% (95%CI: 87.00%-89.31%), and the control rate was 22.67% (95%CI: 21.25%-24.09%), the treatment control rate was 27.76% (95%CI: 26.09%-29.42%). Multivariate analysis showed that patients in urban areas as well as in rural areas who were aged over 65 years old (OR=1.40, 95%CI: 1.05-1.87; OR=3.11, 95%CI: 2.22-4.36), taking medicine as prescribed (OR=2.15, 95%CI: 1.46-3.15; OR=1.35, 95%CI: 1.13-1.62), monitoring blood pressure (OR=2.34, 95%CI: 1.88-2.90; OR=3.10, 95%CI: 2.72-3.53) were more willing to accept community health management of hypertension. Urban hypertension patients with high education level (OR=0.51, 95%CI: 0.39-0.66), moderate alcohol consumption (OR=0.69, 95%CI: 0.57-0.84) or excessive alcohol consumption (OR=0.73, 95%CI: 0.58-0.92) had a poor acceptance of community hypertension management. Overweight (OR=0.74, 95%CI: 0.61-0.91; OR=0.83, 95%CI: 0.71-0.98), obesity (OR=0.54, 95%CI: 0.45-0.65; OR= 0.67, 95%CI: 0.54-0.83) patients in urban areas as well as in rural areas with hypertension had poor blood pressure control, and patient taking medication as prescribed (OR=4.58, 95%CI: 3.16-6.63; OR=2.84, 95%CI: 2.18-3.69) had better blood pressure control. Urban hypertension patients in central China (OR=0.74, 95%CI: 0.61-0.89) or with excessive alcohol consumption (OR=0.72, 95%CI: 0.54-0.97) had poor blood pressure control while urban hypertension patients with other chronic diseases (OR=1.22, 95%CI: 1.04-1.44) and participating in standardized hypertension community management (OR=1.29, 95%CI: 1.06-1.58) had better blood pressure control. Rural hypertension patients who located in central and western China (OR=0.71, 95%CI: 0.58-0.87; OR=0.62, 95%CI: 0.47-0.80), with moderate alcohol consumption (OR=0.81, 95%CI: 0.67-0.98), taking salt more than 6 g per day (OR=0.80, 95%CI: 0.69-0.93) had poor blood pressure control, and the rural hypertension patients who underwent blood pressure monitoring (OR=1.38, 95%CI: 1.18-1.61) had better blood pressure control. Conclusions The community health management of hypertension in patients aged 35 years and above has been improved in China, but there is still a certain gap between the control of hypertension and related indicators. It is necessary to take multi standardized intervention measures for the better prevention and control of hypertension. 【Key words】 Hypertension patient; Community management; Blood pressure control; Influencing factor Fund program: National Key Research and Development Program of China (2018YFC1311706) Publisher Copyright: © 2021 British HIV Association
PY - 2021
Y1 - 2021
N2 - Objectives: Although direct-acting antivirals (DAAs) can clear HCV in nearly all HIV/HCV-coinfected individuals, high rates of reinfection may hamper efforts to eliminate HCV in this population. We investigated reinfection after sustained virological response (SVR) in HIV/HCV-coinfected individuals in Europe. Methods: Factors associated with odds of reinfection by 2 years after SVR in EuroSIDA participants with one or more HCV-RNA test and 2 years follow-up were assessed using logistic regression. Results: Overall, 1022 individuals were included. The median age was 50 (interquartile range: 43–54 years), and most were male (78%), injection drug users (52%), and received interferon (IFN)-free DAAs (62%). By 24 months, 75 [7.3%, 95% confidence interval (CI): 5.7–8.9%] individuals were reinfected. Among individuals treated prior to 2014, 16.1% were reinfected compared with 4.2% and 8.3%, respectively, among those treated during or after 2014 with IFN-free and IFN-based therapy. After adjustment, individuals who had started treatment during or after 2014 with IFN-free or IFN-based therapy had significantly lower odds of reinfection (adjusted odds ratio = 0.21, 95% CI: 0.11–0.38; 0.43, 95% CI: 0.22–0.83) compared with those who had received therapy before 2014. There were no significant differences in odds of reinfection according to age, gender, European region, HIV transmission risk group or liver fibrosis. Conclusions: Among HIV/HCV-coinfected individuals in Europe, 7.3% were reinfected with HCV within 24 months of achieving SVR, with evidence suggesting that this is decreasing over time and with use of newer HCV regimens. Harm reduction to reduce reinfection and surveillance to detect early reinfection with an offer of treatment are essential to eliminate HCV.
AB - Objectives: Although direct-acting antivirals (DAAs) can clear HCV in nearly all HIV/HCV-coinfected individuals, high rates of reinfection may hamper efforts to eliminate HCV in this population. We investigated reinfection after sustained virological response (SVR) in HIV/HCV-coinfected individuals in Europe. Methods: Factors associated with odds of reinfection by 2 years after SVR in EuroSIDA participants with one or more HCV-RNA test and 2 years follow-up were assessed using logistic regression. Results: Overall, 1022 individuals were included. The median age was 50 (interquartile range: 43–54 years), and most were male (78%), injection drug users (52%), and received interferon (IFN)-free DAAs (62%). By 24 months, 75 [7.3%, 95% confidence interval (CI): 5.7–8.9%] individuals were reinfected. Among individuals treated prior to 2014, 16.1% were reinfected compared with 4.2% and 8.3%, respectively, among those treated during or after 2014 with IFN-free and IFN-based therapy. After adjustment, individuals who had started treatment during or after 2014 with IFN-free or IFN-based therapy had significantly lower odds of reinfection (adjusted odds ratio = 0.21, 95% CI: 0.11–0.38; 0.43, 95% CI: 0.22–0.83) compared with those who had received therapy before 2014. There were no significant differences in odds of reinfection according to age, gender, European region, HIV transmission risk group or liver fibrosis. Conclusions: Among HIV/HCV-coinfected individuals in Europe, 7.3% were reinfected with HCV within 24 months of achieving SVR, with evidence suggesting that this is decreasing over time and with use of newer HCV regimens. Harm reduction to reduce reinfection and surveillance to detect early reinfection with an offer of treatment are essential to eliminate HCV.
KW - HCV
KW - HIV
KW - direct-acting antivirals
KW - interferon
KW - reinfection
UR - http://www.scopus.com/inward/record.url?scp=85120978428&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/hiv.13212
DO - https://doi.org/10.1111/hiv.13212
M3 - Article
C2 - 34882940
SN - 1464-2662
JO - HIV medicine
JF - HIV medicine
ER -