Background & Aims
Direct acting antivirals (DAA) lead to high sustained virological response (SVR) rates and decreased the risk of disease progression. We compared SVR rates and all-cause, liver- and non-liver-related deaths, liver-related events and non-liver-related cancers in HIV/HCV co-infected and HCV mono-infected participants from two French cohort studies after initiation of DAA treatment.
Up to 4 HCV mono-infected participants from the ANRS CO22 HEPATHER cohort were matched on age and sex to each HIV/HCV co-infected from the ANRS CO13 HEPAVIH cohort; both are nationwide, prospective, multicentre and observational. Participants initiated DAA between March 2014 and December 2017. Cox proportional Hazards models adjusted on age, sex, duration since HCV diagnosis, HCV transmission routes, HCV genotypes, cirrhosis, tobacco, alcohol consumption, and SVR (time dependent) were used.
592 HIV/HCV co-infected and 2049 HCV mono-infected participants were included. Median age was 53.3 years (interquartile range: 49.6-56.9) and 52.9 years (49.6 ; 56.7), and 1498 (73.1%) and 436 (73.6%) were men, and 159 (28.8%) and 793 (41.2%) were cirrhotic, respectively. SVR was observed in 92.9% and 94.6%, respectively. HIV co-infection was associated with higher risk of all-cause death (hazard ratio [HR] 1.93; 95% confidence interval [CI] 1.01-3.69), non-liver-related death (HR 2.84; 95%CI 1.27-6.36) and non-liver-related cancer (HR 3.26; 95%CI 1.50-7.08), but not with liver-related-death (HR 1.04; 95%CI 0.34-3.15) or liver-related events (HR 0.66; 95% CI 0.31-1.44).
After DAA treatment, HIV co-infected had similar SVR rates and risk of liver-related deaths and events compared to HCV mono-infected but higher risk of all-cause and non-liver-related deaths and non-liver-related cancers.