Successful implementation of hepatitis C virus treatment in two large HIV clinics in Amsterdam: hepatitis C virus treatment cascade of care
The availability of direct-acting antivirals (DAA) has dramatically improved the success of hepatitis C virus (HCV) therapy. DAA treatment became available in the Netherlands in the fourth quarter of 2014 but only for patients with significant liver fibrosis. Since November 2015, treatment is available for all HCV-infected patients. Here, we describe the treatment cascade in HIV–HCV-coinfected individuals in the two largest HIV clinics in the Netherlands. Both are situated in Amsterdam, which is in the center of the recent epidemic of acute HCV among MSM in the Netherlands . In the analysis, we included all HIV-infected patients with a chronic HCV infection, who were in care as per 2014 in the Onze Lieve Vrouwe Gasthuis and the Academic Medical Center in Amsterdam. In accordance with the Dutch HIV treatment guidelines, patients are screened for HCV by transaminases twice a year and serology once a year. Assessment of HCV RNA is at the discretion of the treating physician. Chronic HCV infection was defined as persistent plasma HCV viremia for more than 6 months. Sustained viral response (SVR) was defined as undetectable HCV RNA 12 weeks after the end of treatment (SVR12). Reasons for not initiating HCV treatment were retrospectively assessed.