The Kirby Institute, Wallace Wurth Building, UNSW Sydney, NSW 2051, Australia.
The Kirby Institute, Wallace Wurth Building, UNSW Sydney, NSW 2051, Australia; and Corresponding author. Email:
Sex Health. 2020 Jun;17(3):223-230. doi: 10.1071/SH19101.
Background Unrestricted access to direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has been available in Australia since March 2016. Individuals with HIV-HCV co-infection are at a greater risk of liver fibrosis progression. This study estimated DAA treatment uptake among individuals with HIV-HCV co-infection, during the first year of DAA treatment access in Australia.
Pharmaceutical Benefits Scheme (PBS) data on dispensed DAA and antiretroviral therapy (ART) prescriptions from March 2016 to March 2017 were used for analysis.
During March 2016 to March 2017, a total of 935 individuals with HIV-HCV co-infection were receiving ART and initiated DAA treatment, with 93% to 97% completing their prescribed course. Estimated DAA treatment uptake in the HIV-HCV-infected population was 41% (935/2290). Most were men (94%). Median age was 50 years. DAA treatment was initiated by specialists in 64% of cases (n = 602), and by general practitioners (GPs) in 25% of cases (n = 238). The proportion of individuals initiated on DAA by GPs increased from 20% in March-April 2016 to 26% in January-March 2017. Most specialists (77%) and GPs (72%) initiated DAA treatment for one to three patients. Among individuals initiated on DAA by GPs, 68% received their ART prescription from the same GP.
A high level of DAA treatment uptake and completion was observed among individuals with HIV-HCV co-infection during the first year of DAA treatment access. The proportion of individuals prescribed DAA by GPs increased over time; this is important for broadened access.
自 2016 年 3 月以来，澳大利亚已可无限制地获得直接作用抗病毒（DAA）治疗丙型肝炎病毒（HCV）感染。HIV-HCV 合并感染的个体发生肝纤维化进展的风险更高。本研究旨在估算澳大利亚 DAA 治疗获得途径开放后的第一年中 HIV-HCV 合并感染个体的 DAA 治疗接受率。
分析 2016 年 3 月至 2017 年 3 月期间药品福利计划（PBS）中开具的 DAA 和抗逆转录病毒治疗（ART）处方的药品数据。
在 2016 年 3 月至 2017 年 3 月期间，共有 935 例 HIV-HCV 合并感染个体正在接受 ART 治疗并开始接受 DAA 治疗，其中 93%至 97%完成了规定疗程。HIV-HCV 感染人群中估计的 DAA 治疗接受率为 41%（935/2290）。大多数为男性（94%）。中位年龄为 50 岁。64%（n=602）的病例由专科医生启动 DAA 治疗，25%（n=238）的病例由全科医生（GP）启动。2016 年 3 月至 4 月，由 GP 启动 DAA 治疗的比例为 20%，而 2017 年 1 月至 3 月则上升至 26%。大多数专科医生（77%）和 GP（72%）为 1 至 3 名患者启动了 DAA 治疗。在由 GP 启动 DAA 治疗的个体中，68%的人从同一位 GP 处获得了 ART 处方。
在 DAA 治疗获得途径开放后的第一年中，HIV-HCV 合并感染个体的 DAA 治疗接受率和完成率均较高。由 GP 开具 DAA 处方的比例随时间推移而增加；这对于扩大获得途径很重要。
