Abstract
Background: Although the prevalence and mortality of hepatitis is high in the Asia-Pacific region, few studies are available on the diagnosis, treatment, and cure rates for viral hepatitis among people living with HIV in this area. This study aims to report the cascade of care (CoC) for hepatitis B (HBV) and C (HCV) among people living with HIV receiving combined antiretroviral therapy (ART). Methods: Patients enrolled in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD-LITE) cohort, on ART, and with follow-up data from 2010 to 2019 were included. Patients were determined as positive for HCV or HBV co-infection if they ever tested positive for HCV antibody (anti-HCV) or HBV surface antigen (HBsAg), respectively. Results: In total, 39% (8612/22 340) of the adult HIV cohort had undergone HBsAg testing, with 8% (672/8612) testing positive. HBV CoC demonstrated that 71% (474/672) of those with HBsAg positive results initiated treatment, 67% (318/474) of those on treatment had HBV DNA testing to evaluate treatment progression, and 18% (58/318) of those tested reached viral suppression. Of the cohort, 37% (8231/22 340) had anti-HCV testing, of whom 10% (779/8231) tested positive. The HCV CoC showed that 68% (526/779) of those with positive anti-HCV tests had HCV RNA tests, of whom 51% (267/526) had detectable HCV RNA. Among those with detectable HCV RNA, 65% (174/267) initiated HCV treatment. Of the 40% (69/174) who initiated HCV treatment, 90% (62/69) reached sustained virological response. Conclusion: Our findings identified less frequent testing in the healthcare system and limited access to treatment as gaps in the CoC for viral hepatitis. More routine HCV RNA and HBV DNA testing is required for patients with positive screening tests to identify those in need of treatment.
| Original language | English |
|---|---|
| Journal | HIV Medicine |
| DOIs | |
| Publication status | Accepted/In press - 2022 |
Bibliographical note
Funding Information:This study was supported by the TREAT Asia HIV Observational Database Low-Intensity Transfer study which is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Sydney, Australia. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned. Data are not publicly available because of the conditions of the ethics agreements. PS Ly, V Khol, National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia; MP Lee, PCK Li, TS Kwong, TH Li, Queen Elizabeth Hospital, Hong Kong SAR; N Kumarasamy, C Ezhilarasi, Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), VHS-Infectious Diseases Medical Centre, VHS, Chennai, India; S Pujari, K Joshi, S Gaikwad, A Chitalikar, Institute of Infectious Diseases, Pune, India; TP Merati, DN Wirawan, F Yuliana, Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia; JY Choi, S Na, JM Kim, Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; A Avihingsanon, S Gatechompol, P Phanuphak, C Phadungphon, HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand; S Kiertiburanakul, A Phuphuakrat, L Chumla, N Sanmeema, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; KV Nguyen, HV Bui, DTH Nguyen, DT Nguyen, National Hospital for Tropical Diseases, Hanoi, Vietnam; CD Do, AV Ngo, LT Nguyen, Bach Mai Hospital, Hanoi, Vietnam; AH Sohn, JL Ross, B Petersen, TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand; MG Law, A Jiamsakul, D Rupasinghe, The Kirby Institute, UNSW Sydney, NSW, Australia.
Funding Information:
This study was supported by the TREAT Asia HIV Observational Database Low‐Intensity Transfer study which is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, the National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Sydney, Australia. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned. Data are not publicly available because of the conditions of the ethics agreements. Eunice Kennedy Shriver
Publisher Copyright:
© 2022 British HIV Association.
All Science Journal Classification (ASJC) codes
- Health Policy
- Infectious Diseases
- Pharmacology (medical)
