Only half of people with diagnosed HIV/HCV co-infection in Southern
Europe have ever started a course of treatment to cure hepatitis C
infection, and less than 40% in Central and Eastern Europe, an analysis
people receiving HIV care in the European region shows.
The findings, also presented to EACS 2017 on Friday, by Sarah Amele of University College London, come
from the EuroSIDA study, an amalgamation of HIV treatment cohort studies in Western, Central and Eastern Europe.
The study was designed to evaluate the continuum of care for
hepatitis C in people with HIV/HCV co-infection, from testing to treatment, who were
in care in January 2015.
The researchers identified 6985 people in the EuroSIDA
cohort with a positive HCV antibody test result prior to January 2015. Of
these, 79% had a subsequent test for HCV RNA to diagnose chronic infection –
meaning that almost one in five did not receive a test to determine whether or
not they had active HCV infection. HCV RNA testing is an essential first step
in determining whether a person with HCV antibodies is in need of treatment for
HCV infection. People with HCV antibodies who have a negative HCV RNA are
presumed to have cleared the infection spontaneously.
HCV RNA testing occurred much less frequently in Eastern
Europe than in Western Europe: only 46.4% received an HCV RNA test in Eastern
Europe compared to 93.7% in Western Europe.
People from migrant communities were less likely to receive
an HCV RNA test but people who inject drugs were more likely to receive an
HCV RNA test than the population as a whole.
Of the entire population of people with HCV antibodies, 5027
had a positive HCV RNA result and 57.4% of all people with HCV antibodies
remained HCV RNA positive in January 2015.
Of those who tested HCV RNA positive, 45.3% had an HCV
Less than half of all those diagnosed with chronic infection
had undergone any course of treatment by January 2015 (45.3%) and in the
overwhelming majority of cases the treatment consisted of interferon and
ribavirin. Only 9.4% received a course of interferon-free treatment with
Although 2079 people completed a course of treatment, the
outcome of treatment was documented for only 1305 people due to lack of
virological testing during and after treatment.
Just 285 people with chronic infection were cured of HCV in
the period up to January 2015, approximately 5% of all those diagnosed with
Overall, the study found that substantial proportions of
people were being lost at each stage of the care continuum and that access to
treatment remained poor for people living with HIV.