Treatment of hepatitis C virus in human immunodeficiency virus infected patients in "real life": modifications in two large surveys between 2004 and 2006.
OBJECTIVE
To analyze the barriers to HCV treatment in HIV-HCV co-infected patients and their evolution between 2004 and 2006.


METHODS
Three hundred and eighty HIV-HCV co-infected patients were prospectively included in surveys from November 22 to 29, 2004 (2004 survey), and 416 from April 3 to 10, 2006 (2006 survey).


RESULTS
Patients in 2006 compared to those in 2004 had negative HCV RNA more often (24% vs. 12%). The rate of liver biopsy was similar (56% vs. 54%) while 24% had had a non-invasive liver damage assessment. The rate of previous treatment for HCV infection was higher (48% vs. 26%). The main reasons for HCV non-treatment have changed: HCV treatment deemed questionable (44% vs. 53%), lack of liver biopsy (18% vs. 33%), physicians' conviction of poor patient compliance (20% vs. 30%). In both surveys, HCV treated patients were more often of European origin, had better control of HIV infection, and had a liver damage assessment more often.


CONCLUSIONS
The care of HIV-HCV co-infected patients has changed significantly in "real life". These results underline the importance of continuing efforts to educate physicians and patients in order to increase the access of co-infected patients to HCV treatment.
Cacoub
Patrice
P
Université Pierre et Marie Curie-Paris 6, CNRS, UMR 7087, Paris, France. patrice.cacoub@psl.aphp.fr
Halfon
Philippe
P
Rosenthal
Eric
E
Pialoux
Gilles
G
Benhamou
Yves
Y
Perronne
Christian
C
Pol
Stanislas
S
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001706:Biopsy; D015704:CD4 Antigens / Q000032:analysis; D005260:Female; D005602:France; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D019538:Health Care Surveys; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
D000998:Antiviral Agents; D015704:CD4 Antigens; D012367:RNA, Viral; D007372:Interferons