Hospital Regional Universitario Virgen Of La Victoria

Rincón de la Victoria, Spain

Hospital Regional Universitario Virgen Of La Victoria

Rincón de la Victoria, Spain

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Rivero-Juarez A.,University of Cordoba, Spain | Lopez-Cortes L.F.,University of Seville | Castano M.,Hospital Regional Universitario Carlos Haya | Merino D.,Complejo Hospitalario Universitario Of Huelva | And 15 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2016

In April 2015, the Spanish National Health System (SNHS) developed a national strategic plan for the diagnosis, treatment, and management of hepatitis C virus (HCV). Our aim was to analyze the impact of this on human immunodeficiency virus (HIV)-infected patients included in the HERACLES cohort during the first 6 months of its implementation. The HERACLES cohort (NCT02511496) was set up in March 2015 to evaluate the status and follow-up of chronic HCV infection in patients co-infected with HIV in the south of Spain. In September 2015, the data were analyzed to identify clinical events (death, liver decompensation, and liver fibrosis progression) and rate of treatment implementation in this population. The study population comprised a total of 3474 HIV/HCV co-infected patients. The distribution according to liver fibrosis stage was: 1152 F0–F1 (33.2 %); 513 F2 (14.4 %); 641 F3 (18.2 %); 761 F4 (21.9 %); and 407 whose liver fibrosis was not measured (12.3 %). During follow-up, 248 patients progressed by at least one fibrosis stage [7.1 %; 95 % confidence interval (CI): 6.3–8 %]. Among cirrhotic patients, 52 (6.8 %; 95 % CI: 5.2–8.9 %) developed hepatic decompensation. In the overall population, 50 patients died (1.4 %; 95 % CI: 1.1–1.9 %). Eight hundred and nineteen patients (23.56 %) initiated interferon (IFN)-free treatment during follow-up, of which 47.8 % were cirrhotic. In our study, during 6 months of follow-up, 23.56 % of HIV/HCV co-infected patients included in our cohort received HCV treatment. However, we observed a high incidence of negative short-term outcomes in our population. © 2016 The Author(s)


Rivero-Juarez A.,University of Cordoba, Spain | Gutierrez-Valencia A.,University of Seville | Castano M.,Hospital Regional Universitario Carlos Haya | Merino D.,Complejo Hospitalario Universitario Of Huelva | And 25 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2015

The implementation of hepatitis C (HCV) direct-acting antiviral drugs is prioritized in several populations in which its application provides the most immediate and impactful benefit. In this scenario, a precise knowledge of the situation of human immunodeficiency virus (HIV)/HCV chronic co-infection is required to adequately address this disease. This cross-sectional study was performed in 21 hospitals in Andalusia (Spain). The study population consisted of HIV-infected patients with an active HCV chronic infection who were not receiving HCV treatment at the time of inclusion. A total of 13,506 HIV-infected patients were included in the study. Of them, 2561 (18.9 %) presented chronic HCV infection. The majority of the patients included were on highly active antiretroviral therapy (HAART; 96.2 %), showed plasma levels with an undetectable HIV viral load (92.5 %), and had a good immunological status (median CD4+ cell count of 486 cells/mL). The HCV genotype distribution was as follows: 58.1 % were genotype 1, 1.1 % were genotype 2, 16.1 % were genotype 3, and 22.1 % were genotype 4 (2.6 % were missing data). In total, 24.8 % of the patients showed liver fibrosis stage F0–F1, 27.9 % showed stage F2, 16.7 % showed stage F3, and 21 % showed stage F4 (9.6 % were missing data). With regards to previous HCV treatment experiences, 68.05 % of the patients were naïve and 31.95 % had failed to respond to a previous treatment. The burden of HCV/HIV co-infected patients in our population was reported as one in five HIV-infected patients requiring HCV treatment. The implementation of extra resources to face this important health challenge is mandatory. © 2015, The Author(s).


PubMed | Hospital Regional Universitario Virgen Of La Victoria, Hospital Universitario San Cecilio, Complejo Hospitalario Of Jaen, Hospital Regional Universitario Carlos Haya and 13 more.
Type: | Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology | Year: 2016

In April 2015, the Spanish National Health System (SNHS) developed a national strategic plan for the diagnosis, treatment, and management of hepatitis C virus (HCV). Our aim was to analyze the impact of this on human immunodeficiency virus (HIV)-infected patients included in the HERACLES cohort during the first 6months of its implementation. The HERACLES cohort (NCT02511496) was set up in March 2015 to evaluate the status and follow-up of chronic HCV infection in patients co-infected with HIV in the south of Spain. In September 2015, the data were analyzed to identify clinical events (death, liver decompensation, and liver fibrosis progression) and rate of treatment implementation in this population. The study population comprised a total of 3474 HIV/HCV co-infected patients. The distribution according to liver fibrosis stage was: 1152F0-F1 (33.2%); 513F2 (14.4%); 641F3 (18.2%); 761F4 (21.9%); and 407 whose liver fibrosis was not measured (12.3%). During follow-up, 248 patients progressed by at least one fibrosis stage [7.1%; 95% confidence interval (CI): 6.3-8%]. Among cirrhotic patients, 52 (6.8%; 95% CI: 5.2-8.9%) developed hepatic decompensation. In the overall population, 50 patients died (1.4%; 95% CI: 1.1-1.9%). Eight hundred and nineteen patients (23.56%) initiated interferon (IFN)-free treatment during follow-up, of which 47.8% were cirrhotic. In our study, during 6months of follow-up, 23.56% of HIV/HCV co-infected patients included in our cohort received HCV treatment. However, we observed a high incidence of negative short-term outcomes in our population.


PubMed | Hospital Regional Universitario Virgen Of La Victoria, Hospital Universitario San Cecilio, Complejo Hospitalario Of Jaen, Hospital Regional Universitario Carlos Haya and 9 more.
Type: Journal Article | Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology | Year: 2015

The implementation of hepatitis C (HCV) direct-acting antiviral drugs is prioritized in several populations in which its application provides the most immediate and impactful benefit. In this scenario, a precise knowledge of the situation of human immunodeficiency virus (HIV)/HCV chronic co-infection is required to adequately address this disease. This cross-sectional study was performed in 21 hospitals in Andalusia (Spain). The study population consisted of HIV-infected patients with an active HCV chronic infection who were not receiving HCV treatment at the time of inclusion. A total of 13,506 HIV-infected patients were included in the study. Of them, 2561 (18.9%) presented chronic HCV infection. The majority of the patients included were on highly active antiretroviral therapy (HAART; 96.2%), showed plasma levels with an undetectable HIV viral load (92.5%), and had a good immunological status (median CD4+ cell count of 486 cells/mL). The HCV genotype distribution was as follows: 58.1% were genotype 1, 1.1% were genotype 2, 16.1% were genotype 3, and 22.1% were genotype 4 (2.6% were missing data). In total, 24.8% of the patients showed liver fibrosis stage F0-F1, 27.9% showed stage F2, 16.7% showed stage F3, and 21% showed stage F4 (9.6% were missing data). With regards to previous HCV treatment experiences, 68.05% of the patients were nave and 31.95% had failed to respond to a previous treatment. The burden of HCV/HIV co-infected patients in our population was reported as one in five HIV-infected patients requiring HCV treatment. The implementation of extra resources to face this important health challenge is mandatory.

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