Effectiveness of hepatitis C treatment in HIV infection in the Novgorod region

The aim . To study clinical, epidemiological and laboratory indicators of treatment efficacy of viral hepatitis C in HIV-infected patients in the Novgorod region. Materials and methods . The data of primary medical records of HIV-infected patients living in the territory of the Novgorod region with viral hepatitis C co-infection were used for the analysis. The study group included 142 patients receiving hepatitis C treatment from 2014 to 2023. The time of the start of receiving hepatitis C antiviral therapy and duration of treatment, the time of onset of sustained virological response, the hepatitis C antiviral therapy regimen used, the presence and stage of liver fibrosis, the dynamics of biochemical and immunological indices, as well as the antiretroviral therapy regimen used during the period of hepatitis C virus treatment were studied. Quartile methods and methods of statistical significance assessment were used for statistical processing. Results and discussion . Of the subjects, 61% (87 people) were males and 39% (55 people) were females. The most frequent genotype of hepatitis C virus in Novgorod region during the period under study was genotype 1b (40.1% of cases) and 3a (30.3% of cases). Patients with fibrosis degree F3 (24%) and F4 (18%) prevailed in the study group. The distribution of fibrosis degrees F0–F2 was uniform (11–15%). In the studied group of patients, the time interval between the detection of antibodies to hepatitis C (ELISA) and the immediate initiation of antiviral therapy averaged from 1 to 10 years. Sustained virological response by 12 weeks from the start of antiviral therapy was achieved in 94% of cases. There were 4 cases (3%) of ineffectiveness of antiviral therapy of viral hepatitis C. In patients after the start of treatment after one month there was a significant decrease in ALT and AST enzymes (from median values of 70.5 and 51.9, respectively, to median values of 28.8 and 30.0, respectively) with preservation of these values until the end of antiviral therapy and control time (after 12 weeks and 24 weeks, respectively). Conclusions . The most frequent hepatitis C genotypes in HIV-infected patients in Novgorod region are 1b and 3a. At the time of treatment initiation, the majority of those studied already had fibrosis stage F3 or F4 (according to METAVIR). The used schemes of viral hepatitis treatment showed high efficiency with achievement of stable virological response at the 12th week of therapy (in 4 studied cases virological ineffectiveness was noted with subsequent replacement of several PVT schemes) and stabilisation of liver metabolic processes.