Treatment of hepatitis C virus in human immunodeficiency virus infected patients in real life: Modifications in two large surveys between 2004 and 2006

Background/Aims: 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. (c) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.