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1. Predictive Performance of Cardiovascular Disease Risk Prediction Algorithms in People Living With HIV

Author

Zoest, R.A. van, Law, M., Sabin, C.A., Vaartjes, I., Valk, M. van der, Arends, J.E., Reiss, P., Wit, F.W., Geerlings, S.E., Godfried, M.H., Goorhuis, A., Hovius, J.W., Kuijpers, T.W., Nellen, F.J.B., Poll, D.T. van der, Prins, J.M., Vugt, H.J.M. van, Wiersinga, W.J., Wit, F.W.M.N., Duinen, M. van, Eden, J. van, Hes, A.M.H. van, Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S., Back, N.K.T., Zaaijer, H.L., Berkhout, B., Cornelissen, M.T.E., Schinkel, C.J., Wolthers, K.C., Peters, E.J.G., Agtmael, M.A. van, Bomers, M., Heitmuller, M., Laan, L.M., Ang, C.W., Houdt, R. van, Pettersson, A.M., Vandenbroucke-Grauls, C.M.J.E., Berge, M. van den, Stegeman, A., Baas, S., Looff, L.H. de, Wintermans, B., Veenemans, J., Pronk, M.J.H., Ammerlaan, H.S.M., Munnik, E.S. de, Jansz, A.R., Tjhie, J., Wegdam, M.C.A., Deiman, B., Scharnhorst, V., Eeden, A. van, Brokking, W., Groot, M., Elsenburg, L.J.M., Damen, M., Kwa, I.S., Kasteren, M.E.E. van, Brouwer, A.E., Erve, R. van, Kruijf-van de Wiel, B.A.F.M. de, Ven, B. van de, Buiting, A.G.M., Kabel, P.J., Versteeg, D., Ende, M.E. van der, Bax, H.I., Gorp, E.C.M. van, Nouwen, J.L., Rijnders, B.J.A., Schurink, C.A.M., Verbon, A., Vries-Sluijs, T.E.M.S. de, Jong-Peltenburg, N.C. de, Bassant, N., Beek, J.E.A. van, Vriesde, M., Zonneveld, L.M. van, Berg-Cameron, H.J. van den, Groot, J. de, Zeeuw-de Man, M. de, Boucher, C.A.B., Koopmans, M.P.G., Kampen, J.J.A. van, Pas, S.D., Branger, J., Douma, R.A., Duijf-van de Ven, C.J.H.M., Schippers, E.F., Nieuwkoop, C. van, IJperen, J.M. van, Geilings, J., Hut, G. van der, Burgel, N.D. van, Leyten, E.M.S., Gelinck, L.B.S., Davids-Veldhuis, S., Hartingsveld, A.Y. van, Meerkerk, C., Wildenbeest, G.S., Heikens, E., Groeneveld, P.H.P., Bouwhuis, J.W., Lammers, A.J.J., Kraan, S., Hulzen, A.G.W. van, Kruiper, M.S.M., Bliek, G.L. van der, Bor, P.C.J., Bloembergen, P., Wolfhagen, M.J.H.M., Ruijs, G.J.H.M., Kroon, F.P., Boer, M.G.J. de, Scheper, H., Jolink, H., Dorama, W., Holten, N. van, Claas, E.C.J., Wessels, E., Hollander, J.G. den, Pogany, K., Roukens, A., Kastelijns, M., Smit, J.V., Smit, E., Struik-Kalkman, D., Tearno, C., Niekerk, T. van, Pontesilli, O., Lowe, S.H., Lashof, A.M.L.O., Posthouwer, D., Ackens, R.P., Burgers, K., Schippers, J., Weijenberg-Maes, B., Loo, I.H.M. van, Havenith, T.R.A., Mulder, J.W., Vrouenraets, S.M.E., Lauw, F.N., Broekhuizen, M.C. van, Vlasblom, D.J., Smits, P.H.M., Weijer, S., Moussaoui, R. el, Bosma, A.S., Vonderen, M.G.A. van, Kampschreur, L.M., Dijkstra, K., Faber, S., Weel, J., Kootstra, G.J., Delsing, C.E., Burg-van de Plas, M. van der, Heins, H., Kortmann, W., Twillert, G. van, Renckens, R., Ruiter-Pronk, D., Truijen-Oud, F.A. van, Stuart, J.W.T.C., IJzerman, E.P., Jansen, R., Reijden, W.A. van der, Brinkman, K., Berk, G.E.L. van den, Blok, W.L., Frissen, P.H.J., Lettinga, K.D., Schouten, W.E.M., Veenstra, J., Brouwer, C.J., Geerders, G.F., Hoeksema, K., Kleene, M.J., Meche, I.B. van der, Spelbrink, M., Toonen, A.J.M., Wijnands, S., Kwa, D., Regez, R., Crevel, R. van, Keuter, M., Ven, A.J.A.M. van der, Hofstede, H.J.M. ter, Dofferhoff, A.S.M., Hoogerwerf, J., Grintjes-Huisman, K.J.T., Haan, M. de, Marneef, M., Rahamat-Langendoen, J., Stelma, F.F., Burger, D., Gisolf, E.H., Hassing, R.J., Claassen, M., Beest, G. ter, Bentum, P.H.M. van, Langebeek, N., Tiemessen, R., Swanink, C.M.A., Lelyveld, S.F.L. van, Soetekouw, R., Prijt, L.M.M. van der, Swaluw, J. van der, Bermon, N., Herpers, B.L., Veenendaal, D., Verhagen, D.W.M., Wijk, M. van, Bierman, W.F.W., Bakker, M., Kleinnijenhuis, J., Kloeze, E., Stienstra, Y., Wilting, K.R., Wouthuyzen-Bakker, M., Boonstra, A., Meulen, P.A. van der, Weerd, D.A. de, Niesters, H.G.M., Leer-Buter, C.C. van, Knoester, M., Hoepelman, A.I.M., Barth, R.E., Bruns, A.H.W., Ellerbroek, P.M., Mudrikova, T., Oosterheert, J.J., Schadd, E.M., Wassenberg, M.W.M., Zoelen, M.A.D. van, Aarsman, K., Elst-Laurijssen, D.H., Rozemeijer, Graduate School, AII - Infectious diseases, APH - Aging & Later Life, Infectious diseases, Global Health, APH - Digital Health, APH - Personalized Medicine, APH - Global Health, Microbes in Health and Disease (MHD), Neurochirurgie, RS: MHeNs - R3 - Neuroscience, Med Microbiol, Infect Dis & Infect Prev, MUMC+: DA MMI Staf (9), RS: CAPHRI - R4 - Health Inequities and Societal Participation, Internal medicine, Pediatric surgery, Amsterdam Movement Sciences - Rehabilitation & Development, ACS - Diabetes & metabolism, AGEM - Digestive immunity, Medical Microbiology and Infection Prevention, Amsterdam Reproduction & Development (AR&D), Internal Medicine, Virology, and Medical Microbiology & Infectious Diseases

Subjects
Male, Heart disease, Human immunodeficiency virus (HIV), risk prediction algorithms, Blood Pressure, HIV Infections, Disease, 030312 virology, medicine.disease_cause, SUBCLINICAL ATHEROSCLEROSIS, Risk Factors, cardiovascular disease, FRAMINGHAM, Pharmacology (medical), Netherlands, 0303 health sciences, INFECTED PATIENTS, Framingham Risk Score, Middle Aged, Prediction algorithms, Cholesterol, Infectious Diseases, Anti-Retroviral Agents, Cardiovascular Diseases, HUMAN-IMMUNODEFICIENCY-VIRUS, Female, Risk assessment, Algorithms, Adult, Anti-HIV Agents, CARDIOLOGY/AMERICAN HEART ASSOCIATION, HEART-DISEASE, AMERICAN-COLLEGE, DATA-COLLECTION, Risk Assessment, EVENTS, 03 medical and health sciences, SDG 3 - Good Health and Well-being, INFLAMMATION, Environmental health, SCORE, medicine, Humans, Propensity Score, business.industry, HIV, medicine.disease, CD4 Lymphocyte Count, MYOCARDIAL-INFARCTION, Propensity score matching, Disease risk, business
Abstract

Background: People living with HIV (PLWH) experience a higher cardiovascular disease (CVD) risk. Yet, traditional algorithms are often used to estimate CVD risk. We evaluated the performance of 4 commonly used algorithms.Setting: The Netherlands.Methods: We used data from 16,070 PLWH aged > 18 years, who were in care between 2000 and 2016, had no pre-existing CVD, had initiated first combination antiretroviral therapy >1 year ago, and had available data on CD4 count, smoking status, cholesterol, and blood pressure. Predictive performance of 4 algorithms [Data Collection on Adverse Effects of Anti-HIV Drugs Study (D: A: D); Systematic COronary Risk Evaluation adjusted for national data (SCORE-NL); Framingham CVD Risk Score (FRS); and American College of Cardiology and American Heart Association Pooled Cohort Equations (PCE)] was evaluated using a Kaplan-Meier approach. Model discrimination was assessed using Harrell's C-statistic. Calibration was assessed using observed-versusexpected ratios, calibration plots, and Greenwood-Nam-D'Agostino goodness-of-fit tests.Results: All algorithms showed acceptable discrimination (Harrell's C-statistic 0.73-0.79). On a population level, D: A: D, SCORE-NL, and PCE slightly underestimated, whereas FRS slightly overestimated CVD risk (observed-versus-expected ratios 1.35, 1.38, 1.14, and 0.92, respectively). D: A: D, FRS, and PCE best fitted our data but still yielded a statistically significant lack of fit (Greenwood-Nam-D'Agostino chi(2) ranged from 24.57 to 34.22, P Conclusions: All algorithms perform reasonably well in PLWH, with SCORE-NL performing poorest. Prediction algorithms are useful for clinical practice, but clinicians should be aware of their limitations (ie, lack of fit and slight underestimation of CVD risk in low-risk groups).

Published
2019

2. High treatment uptake in human immunodeficiency virus/ hepatitis C virus-coinfected patients after unrestricted access to direct-acting antivirals in the Netherlands

Author

Boerekamps, A. (Anne), Newsum, A.M. (Astrid M.), Smit, C. (Colette), Arends, J.E. (Joop), Richter, C. (Clemens), Reiss, P. (Peter), Rijnders, B.J.A. (Bart), Brinkman, K. (Kees), Valk, M. (Marc) van der, Geerlings, S.E. (Suzanne), Godfried, M.H., Goorhuis, A. (Abraham), Hovius, J.W.R. (Joppe), Meer, J.T.M. (J. T M) van der, Kuijpers, T.W. (Taco W.), Nellen, F.J.B. (F. J B), Van Der Poll, D.T. (D. T.), Prins, J.M. (Jan), Van Vugt, H.J.M. (H. J.M.), Wiersinga, W.J. (W. J.), Wit, F.W.N.M. (Ferdinand), Van Duinen, M. (M.), Van Eden, J., Van Hes, A.M.H., Mutschelknauss, M., Nobel, H.E., Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S. (Suzanne), Back, N. (Nicole), Zaaijer, H.L. (Hans), Berkhout, B. (Ben), Cornelissen, M. (Marion), Schinkel, C.J., Wolthers, K.C. (Katja), Van Den Berge, M., Stegeman, A., Baas, S., Hage De Looff, L. (L.), Wintermans, B. (B.), Veenemans, J. (J.), Pronk, M.J.H. (Marjolijn), Ammerlaan, H.S.M. (Heidi), De Munnik, E.S., Jansz, A.R. (A. R.), Tjhie, J. (J.), Wegdam, M.C.A., Deiman, B. (B.), Scharnhorst, V., Eeden, A. (Arne) van, Brokking, W. (W.), Groot, M.M. (Marieke), Elsenburg, L.J.M. (L. J.M.), Damen, M. (M.), Kwa, I.S., Kasteren, M.E.E. (Marjo) van, Brouwer, A.E., Van Erve, R. (R.), De Kruijf-Van De Wiel, B.A.F.M. (B. A.F.M.), Keelan-Pfaf, S. (S.), Van Der Ven, B. (B.), Van Der Ven, B., Buiting, A.G.M. (Anton), Kabel, P.J. (P. J.), Versteeg, D., Ende, M.E. (Marchina) van der, Bax, H.I. (Hannelore), Gorp, E.C.M. (Eric) van, Nouwen, J.L. (Jan), Schurink, C.A.M. (Carolina), Verbon, A. (Annelies), Vriessluijs, T.E.M.S. (Theodora) de, De Jong-Peltenburg, N.C. (N. C.), Bassant, N., Van Beek, J.E.A., Vriesde, M., van Zonneveld, L. (Laura), Van Den Berg-Cameron, H.J., Groot, J.C. (Jan Cees) de, De Zeeuw-De Man, M., Boucher, C.A.B. (Charles), Koopmans D.V.M., M.P.G. (Marion), Kampen, J.J.A. (Jeroen) van, Pas, S.D. (Suzan), Branger, J., Rijkeboer-Mes, A. (A.), Duijf-Van De Ven, C.J.H.M., Schippers, E.F. (E. F.), Nieuwkoop, C. (Cees) van, Van IJperen, J.M. (J. M.), Geilings, J. (J.), Van Der Hut, G., Burgel, N.D. (Nathalie ) van, Leyten, E.M.S. (Eliane), Gelinck, L.B.S. (Luc), Van Hartingsveld, A.Y. (A. Y.), Meerkerk, C., Wildenbeest, G.S., Heikens, E. (E.), Groeneveld, P.H.P. (P. H.P.), Bouwhuis, J.W. (Jolande), Lammers, A.J.J. (A. J.J.), Kraan, S. (S.), Van Hulzen, A.G.W., Van Der Bliek, G.L. (G. L.), Bor, P.C.J., Bloembergen, P. (Peter), Wolfhagen, M.J.H.M., Ruijs, G. (G.), Kroon, F.P. (F. P.), Boer, M.G.J. (Mark) de, Scheper, H. (H.), Jolink, A. (Albert), Vollaard, A. (Albert), Dorama, W. (Willemien), Van Holten, N. (N.), Claas, E.C.J. (Eric), Wessels, E. (E.), Hollander, J.G. (Jan) den, Pogány, K. (Katalin), Roukens, A. (A.), Kastelijns, M. (M.), Smit, J.V., Smit, E., Struik-Kalkman, D. (D.), Tearno, C. (C.), Van Niekerk, T., Pontesilli, O. (Oscar), Lowe, S.H. (S. H.), Oude Lashof, A. (A.), Posthouwer, D. (Dirk), Ackens, R.P. (R. P.), Burgers, K. (K.), Schippers, J., Weijenberg-Maes, B. (B.), Loo, I. (Inge) van, Havenith, T., Mulder, J.W. (J. W.), Vrouenraets, B.C. (Bart), Lauw, F.N. (F. N.), van Broekhuizen, M. (Marjolein), Vlasblom, D.J., Smits, P.H.M. (Paul), Weijer, S. (S.), El Moussaoui, R., Bosma, A.S. (A. S.), Vonderen, M.G.A. van, Van Houte, D.P.F., Kampschreur, L.M., Dijkstra, K. (K.), Faber, S., Weel, J. (J.), Kootstra, J.G. (Jille), Delsing, C.E. (C. E.), Van Der Burg-Van De Plas, M. (M.), Heins, H., Lucas, E. (E.), Kortmann, B., Van Twillert, G. (G.), Renckens, R. (Rosemarijn), Ruiter-Pronk, D. (D.), Van Truijen-Oud, F.A., Cohen Stuart, J.W.T. (James), IJzerman, E.P.F. (Ed), Jansen, R.J. (Roel), Rozemeijer, W. (Wouter), Van Der Reijden, W.A. (W. A.), Berk, G.E.L. (Guido) van den, Blok, W.L. (Willem), Frissen, P.H.J., Lettinga, K.D. (Kamilla), Schouten, W.E.M.I. (Ineke), Veenstra, J. (Jan), Brouwer, C.J., Geerders, G.F., Hoeksema, K., Kleene, M.J., Van Der Meché, I.B., Spelbrink, M. (M.), Toonen, A.J.M., Wijnands, S. (S.), Kwa, S.L.S. (Stefan), Regez, R.M. (Rosa), Crevel, R. (Reinout) van, Keuter, M. (Monique), Ven, A.D. (Andre´) van, Ter Hofstede, H.J.M. (H. J.M.), Dofferhoff, A.S.M. (Anton), Hoogerwerf, J. (J.), Grintjes-Huisman, K.J.T., De Haan, M. (M.), Marneef, M. (M.), Hairwassers, A. (A.), Rahamat-Langendoen, J. (J.), Stelma, F.F. (Foekje), Burger, D.M. (David), Gisolf, E.H. (Elisabeth), Hassing, R.J. (Robert), Claassen, M.A.A. (Mark), Ter Beest, G. (G.), Van Bentum, P.H.M., Langebeek, N. (Nienke), Tiemessen, R. (R.), Swanink, C. (Caroline), Lelyveld, S.F.L. van, Soetekouw, R. (Robert), Van Der Prijt, L.M.M., Van Der Swaluw, J. (J.), Bermon, N. (N.), Jansen, R. (R.), Herpers, B.L. (B. L.), Veenendaal, D. (Dick), Verhagen, D.W.M. (Dominique), Van Wijk, M. (M.), Bierman, W.F.W. (Wouter), Bakker, M. (M.), Kleinnijenhuis, J. (J.), Kloeze, E. (E.), Stienstra, Y. (Y.), Wilting, K.R., Wouthuyzen-Bakker, M. (Marjan), Boonstra, P.A. (André), Van Der Meulen, P.A., De Weerd, D.A., Niesters, H.G.M. (Bert), Van Leer-Buter, C. (Coretta), Knoester, M. (M.), Hoepelman, I.M. (Ilja Mohandas), Barth, R.E. (R. E.), Bruns, A.H.W. (A. H.W.), Ellerbroek, P.M. (P.), Mudrikova, T. (Tania Tania), Oosterheert, J.J. (Jan Jelrik), Schadd, E.M. (E. M.), Wassenberg, M.W.M., Van Zoelen, M.A.D. (M. A.D.), Aarsman, K. (K.), Van Elst-Laurijssen, D.H.M. (D. H.M.), De Kroon, I. (I.), Van Rooijen, C.S.A.M. (C. S.A.M.), Van Berkel, M. (M.), Schuurman, R. (Rob), Verduyn-Lunel, F., Wensing, A. (Amj), Peters, E.J.G., Van Agtmael, M.A. (M. A.), Bomers, M., Heitmuller, M. (M.), Laan, L.M., Ang, C.W. (Wim), Houdt, R. van, Pettersson, A. (Annika), Vandenbroucke-Grauls, C.M.J.E. (Christina), Bezemer, D.O. (Daniela), Sighem, A.I. (Ard) van, Smit, C. (Cees), Wit, F. (Ferdinand), Boender, T.S. (T. S.), Zaheri, S. (S.), Hillebregt, M.M.J. (Mariska), De Jong, A., Bergsma, D., Grivell, S., Jansen, A. (A.), Raethke, M., Meijering, R., Rutkens, T. (T.), De Groot, L. (L.), Van Den Akker, M. (M.), Bakker, Y., Bezemer, M. (M.), Claessen, E., El Berkaoui, A. (A.), Geerlinks, J. (J.), Koops, J. (J.), Kruijne, E., Lodewijk, C., Van Der Meer, R. (R.), Munjishvili, L., Paling, F. (F.), Peeck, B., Ree, C., Regtop, R., Ruijs, Y., Schoorl, M. (Marianne), Timmerman, A. (A.), Tuijn, E., Veenenberg, L., Van Der Vliet, S. (S.), Wisse, A. (A.), De Witte, E.C. (E. C.), Woudstra, T., Tuk, B. (B.), Boerekamps, A. (Anne), Newsum, A.M. (Astrid M.), Smit, C. (Colette), Arends, J.E. (Joop), Richter, C. (Clemens), Reiss, P. (Peter), Rijnders, B.J.A. (Bart), Brinkman, K. (Kees), Valk, M. (Marc) van der, Geerlings, S.E. (Suzanne), Godfried, M.H., Goorhuis, A. (Abraham), Hovius, J.W.R. (Joppe), Meer, J.T.M. (J. T M) van der, Kuijpers, T.W. (Taco W.), Nellen, F.J.B. (F. J B), Van Der Poll, D.T. (D. T.), Prins, J.M. (Jan), Van Vugt, H.J.M. (H. J.M.), Wiersinga, W.J. (W. J.), Wit, F.W.N.M. (Ferdinand), Van Duinen, M. (M.), Van Eden, J., Van Hes, A.M.H., Mutschelknauss, M., Nobel, H.E., Pijnappel, F.J.J., Weijsenfeld, A.M., Jurriaans, S. (Suzanne), Back, N. (Nicole), Zaaijer, H.L. (Hans), Berkhout, B. (Ben), Cornelissen, M. (Marion), Schinkel, C.J., Wolthers, K.C. (Katja), Van Den Berge, M., Stegeman, A., Baas, S., Hage De Looff, L. (L.), Wintermans, B. (B.), Veenemans, J. (J.), Pronk, M.J.H. (Marjolijn), Ammerlaan, H.S.M. (Heidi), De Munnik, E.S., Jansz, A.R. (A. R.), Tjhie, J. (J.), Wegdam, M.C.A., Deiman, B. (B.), Scharnhorst, V., Eeden, A. (Arne) van, Brokking, W. (W.), Groot, M.M. (Marieke), Elsenburg, L.J.M. (L. J.M.), Damen, M. (M.), Kwa, I.S., Kasteren, M.E.E. (Marjo) van, Brouwer, A.E., Van Erve, R. (R.), De Kruijf-Van De Wiel, B.A.F.M. (B. A.F.M.), Keelan-Pfaf, S. (S.), Van Der Ven, B. (B.), Van Der Ven, B., Buiting, A.G.M. (Anton), Kabel, P.J. (P. J.), Versteeg, D., Ende, M.E. (Marchina) van der, Bax, H.I. (Hannelore), Gorp, E.C.M. (Eric) van, Nouwen, J.L. (Jan), Schurink, C.A.M. (Carolina), Verbon, A. (Annelies), Vriessluijs, T.E.M.S. (Theodora) de, De Jong-Peltenburg, N.C. (N. C.), Bassant, N., Van Beek, J.E.A., Vriesde, M., van Zonneveld, L. (Laura), Van Den Berg-Cameron, H.J., Groot, J.C. (Jan Cees) de, De Zeeuw-De Man, M., Boucher, C.A.B. (Charles), Koopmans D.V.M., M.P.G. (Marion), Kampen, J.J.A. (Jeroen) van, Pas, S.D. (Suzan), Branger, J., Rijkeboer-Mes, A. (A.), Duijf-Van De Ven, C.J.H.M., Schippers, E.F. (E. F.), Nieuwkoop, C. (Cees) van, Van IJperen, J.M. (J. M.), Geilings, J. (J.), Van Der Hut, G., Burgel, N.D. (Nathalie ) van, Leyten, E.M.S. (Eliane), Gelinck, L.B.S. (Luc), Van Hartingsveld, A.Y. (A. Y.), Meerkerk, C., Wildenbeest, G.S., Heikens, E. (E.), Groeneveld, P.H.P. (P. H.P.), Bouwhuis, J.W. (Jolande), Lammers, A.J.J. (A. J.J.), Kraan, S. (S.), Van Hulzen, A.G.W., Van Der Bliek, G.L. (G. L.), Bor, P.C.J., Bloembergen, P. (Peter), Wolfhagen, M.J.H.M., Ruijs, G. (G.), Kroon, F.P. (F. P.), Boer, M.G.J. (Mark) de, Scheper, H. (H.), Jolink, A. (Albert), Vollaard, A. (Albert), Dorama, W. (Willemien), Van Holten, N. (N.), Claas, E.C.J. (Eric), Wessels, E. (E.), Hollander, J.G. (Jan) den, Pogány, K. (Katalin), Roukens, A. (A.), Kastelijns, M. (M.), Smit, J.V., Smit, E., Struik-Kalkman, D. (D.), Tearno, C. (C.), Van Niekerk, T., Pontesilli, O. (Oscar), Lowe, S.H. (S. H.), Oude Lashof, A. (A.), Posthouwer, D. (Dirk), Ackens, R.P. (R. P.), Burgers, K. (K.), Schippers, J., Weijenberg-Maes, B. (B.), Loo, I. (Inge) van, Havenith, T., Mulder, J.W. (J. W.), Vrouenraets, B.C. (Bart), Lauw, F.N. (F. N.), van Broekhuizen, M. (Marjolein), Vlasblom, D.J., Smits, P.H.M. (Paul), Weijer, S. (S.), El Moussaoui, R., Bosma, A.S. (A. S.), Vonderen, M.G.A. van, Van Houte, D.P.F., Kampschreur, L.M., Dijkstra, K. (K.), Faber, S., Weel, J. (J.), Kootstra, J.G. (Jille), Delsing, C.E. (C. E.), Van Der Burg-Van De Plas, M. (M.), Heins, H., Lucas, E. (E.), Kortmann, B., Van Twillert, G. (G.), Renckens, R. (Rosemarijn), Ruiter-Pronk, D. 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Abstract

Background The Netherlands has provided unrestricted access to direct-acting antivirals (DAAs) since November 2015. We analyzed the nationwide hepatitis C virus (HCV) treatment uptake among patients coinfected with human immunodeficiency virus (HIV) and HCV. Methods Data were obtained from the ATHENA HIV observational cohort in which >98% of HIV-infected patients ever registered since 1998 are included. Patients were included if they ever had 1 positive HCV RNA result, did not have spontaneous clearance, and were known to still be in care. Treatment uptake and outcome were assessed. When patients were treated more than once, data were included from only the most recent treatment episode. Data were updated until February 2017. In addition, each treatment center was queried in April 2017 for a data update on DAA treatment and achieved sustained virological response. Results Of 23574 HIV-infected patients ever linked to care, 1471 HCV-coinfected patients (69% men who have sex with men, 15% persons who [formerly] injected drugs, and 15% with another HIV transmission route) fulfilled the inclusion criteria. Of these, 87% (1284 of 1471) had ever initiated HCV treatment between 2000 and 2017, 76% (1124 of 1471) had their HCV infection cured; DAA treatment results were pending in 6% (92 of 1471). Among men who have sex with men, 83% (844 of 1022) had their HCV infection cured, and DAA treatment results were pending in 6% (66 of 1022). Overall, 187 patients had never initiated treatment, DAAs had failed in 14, and a pegylated interferon-alfa–based regimen had failed in 54. Conclusions Fifteen months after unrestricted DAA availability the majority of HIV/HCV-coinfected patients in the Netherlands have their HCV infection cured (76%) or are awaiting DAA treatment results (6%). This rapid treatment scale-up may contribute to future HCV elimination among these patients.

Published
2018
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