Estimated uptake of hepatitis C direct-acting antiviral treatment among individuals with HIV co-infection in Australia: a retrospective cohort study

摘要

Background Unrestricted access to direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has been available in Australia since March 2016. Individuals with HIV-HCV co-infection are at a greater risk of liver fibrosis progression. This study estimated DAA treatment uptake among individuals with HIV-HCV co-infection, during the first year of DAA treatment access in Australia.Methods:Pharmaceutical Benefits Scheme (PBS) data on dispensed DAA and antiretroviral therapy (ART) prescriptions from March 2016 to March 2017 were used for analysis.Results:During March 2016 to March 2017, a total of 935 individuals with HIV-HCV co-infection were receiving ART and initiated DAA treatment, with 93% to 97% completing their prescribed course. Estimated DAA treatment uptake in the HIV-HCV-infected population was 41% (935/2290). Most were men (94%). Median age was 50 years. DAA treatment was initiated by specialists in 64% of cases (n= 602), and by general practitioners (GPs) in 25% of cases (n= 238). The proportion of individuals initiated on DAA by GPs increased from 20% in March-April 2016 to 26% in January-March 2017. Most specialists (77%) and GPs (72%) initiated DAA treatment for one to three patients. Among individuals initiated on DAA by GPs, 68% received their ART prescription from the same GP.Conclusions:A high level of DAA treatment uptake and completion was observed among individuals with HIV-HCV co-infection during the first year of DAA treatment access. The proportion of individuals prescribed DAA by GPs increased over time; this is important for broadened access.