title: High HCV treatment uptake in the Swedish HIV/HCV co-infected cohort.
abstract: BACKGROUND
  HCV co-infection is a leading cause of death in HIV-positive patients. Despite a strong indication for the treatment of HCV, treatment uptake is generally lower than in HCV mono-infected patients. The aim of this study was to determine the HCV treatment uptake and to define factors associated with initiation or deferral of HCV treatment in Swedish HIV/HCV co-infected patients.
  
  
  METHODS
  All 5315 adult HIV-positive patients in Sweden are included in the InfCare HIV database. Demographic, virologic, and treatment data for 652 HIV/HCV co-infected patients were extracted from this database in September 2010. Factors associated with initiation of interferon-based HCV treatment were analysed. Patient- and physician-reported reasons for deferring HCV treatment were investigated in a subgroup.
  
  
  RESULTS
  The anti-HCV prevalence was 14% and the chronic HCV infection rate 11%. In total, 25% of HIV/HCV co-infected patients had initiated HCV treatment. HCV genotype 2 or 3, HIV transmission route other than intravenous drug use, and ongoing HIV treatment were factors associated with a higher HCV treatment rate. The main reason for not having initiated HCV treatment was intravenous drug use or alcohol abuse.
  
  
  CONCLUSIONS
  The 14% prevalence of anti-HCV noted in Swedish HIV-infected patients was low by international comparisons. The 25% HCV treatment rate noted in our HIV/HCV co-infected patients was high and of the same magnitude as that published for HCV mono-infected patients in Sweden. People who inject drugs had the lowest HCV treatment uptake.
authors.affiliation: From the Unit of Infectious Diseases, Department of Medicine , Huddinge , Karolinska Institutet , Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Stenkvist
authors.forename: Ola
authors.initials: O
authors.lastname: Weiland
authors.forename: Anders
authors.initials: A
authors.lastname: Sönnerborg
authors.forename: Anders
authors.initials: A
authors.lastname: Blaxhult
authors.forename: Karolin
authors.initials: K
authors.lastname: Falconer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy*; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013548:Sweden; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha
keywords: HCV treatment uptake; HIV/HCV co-infection