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Modelling the impact of deferring HCV treatment on liver-related complications in HIV coinfected men who have sex with men.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Zahnd Cindy, Salazar-Vizcaya Luisa, Dufour Jean-François, Müllhaupt Beat, Wandeler Gilles, Kouyos Roger, Estill Janne, Bertisch Barbara, Rauch Andri, Keiser Olivia,
Project Understanding and Predicting the Hepatitis C Epidemic in HIV-infected Patients
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Original article (peer-reviewed)

Journal Journal of hepatology
Volume (Issue) 65(1)
Page(s) 26 - 32
Title of proceedings Journal of hepatology
DOI 10.1016/j.jhep.2016.02.030

Open Access

Type of Open Access Publisher (Gold Open Access)


Hepatitis C (HCV) is a leading cause of morbidity and mortality in people who live with HIV. In many countries, access to direct acting antiviral agents to treat HCV is restricted to individuals with advanced liver disease (METAVIR stage F3 or F4). Our goal was to estimate the long term impact of deferring HCV treatment for men who have sex with men (MSM) who are coinfected with HIV and often have multiple risk factors for liver disease progression. We developed an individual-based model of liver disease progression in HIV/HCV coinfected MSM. We estimated liver-related morbidity and mortality as well as the median time spent with replicating HCV infection when individuals were treated in liver fibrosis stages F0, F1, F2, F3 or F4 on the METAVIR scale. The percentage of individuals who died of liver-related complications was 2% if treatment was initiated in F0 or F1. It increased to 3% if treatment was deferred until F2, 7% if it was deferred until F3 and 22% if deferred until F4. The median time individuals spent with replicating HCV increased from 5years if treatment was initiated in F2 to almost 15years if it was deferred until F4. Deferring HCV therapy until advanced liver fibrosis is established could increase liver-related morbidity and mortality in HIV/HCV coinfected individuals, and substantially prolong the time individuals spend with a replicating HCV infection.