Treatment outcomes and costs of a simplified antiretroviral treatment strategy for hepatitis C among Hepatitis C Virus and Human Immuno deficiency Virus co‐infected patients in Ukraine
Sergie Antoniak,
Charles S Chasela,
Morgan Julie Freiman,
Yulia Stopolianska,
Tetiana Barnard,
Malini M Gandhi,
Maria Liulchuk,
Zhanna Tsenilova,
Tretiakov Viktor,
Jeri Dible,
Constance Wose Kinge,
Francis Akpan,
Thomas Minior,
Ntombi Sigwebela,
Sofiane Mohamed,
Matthiue Barralon,
Fadzai Marange,
Clint Cavenaugh,
Charles Vander Horst,
Svitlana Antonyak,
Thembisile Xulu,
Kara W Chew,
Ian Sanne,
Sydney Rosen,
for EQUIP Health
Affiliations
Sergie Antoniak
Right to Care Kyiv Ukraine
Charles S Chasela
Right to Care Pretoria South Africa
Morgan Julie Freiman
Boston University Boston Massachusetts USA
Yulia Stopolianska
Right to Care Kyiv Ukraine
Tetiana Barnard
United States Agency for International Development Washington District of Columbia USA
Malini M Gandhi
David Geffen School of Medicine at University of California Los Angeles Los Angeles California USA
Maria Liulchuk
Public Health Centre of Ministry of Healthcare of Ukraine Kyiv Ukraine
Zhanna Tsenilova
Alliance for Public Health Kyiv Ukraine
Tretiakov Viktor
100%Life Kyiv Ukraine
Jeri Dible
United States Agency for International Development Washington District of Columbia USA
Constance Wose Kinge
Right to Care Pretoria South Africa
Francis Akpan
Right to Care Pretoria South Africa
Thomas Minior
United States Agency for International Development Washington District of Columbia USA
Ntombi Sigwebela
Right to Care Pretoria South Africa
Sofiane Mohamed
Advanced Biological Laboratories (ABL) Luxembourg City Luxembourg
Matthiue Barralon
Advanced Biological Laboratories (ABL) Luxembourg City Luxembourg
Fadzai Marange
Right to Care Pretoria South Africa
Clint Cavenaugh
United States Agency for International Development Washington District of Columbia USA
Charles Vander Horst
University of North Carolina, Chapel Hill Chapel Hill North Carolina USA
Svitlana Antonyak
Gromashevsky Research Institute of Epidemiology and Infectious Diseases Medical Academy of Sciences of Ukraine Kyiv Ukraine
Thembisile Xulu
Right to Care Pretoria South Africa
Kara W Chew
David Geffen School of Medicine at University of California Los Angeles Los Angeles California USA
Abstract Background and Aim To demonstrate the use of a standard dose of ledipasvir (LDV) and sofosbuvir (SOF), with or without ribavirin, to treat hepatitis C and hepatitis C/HIV co‐infection in Ukraine. Methods Eligible HCV viraemic adults from two clinics in Kyiv were treated with LDV/SOF with or without weight‐based ribavirin for 12 weeks. Clinical assessments were performed at screening and at week 24, and as needed; treatment was dispensed every 4 weeks. The primary outcome was sustained virologic response (SVR) 12 weeks after treatment, with analysis by intention to treat. Cost per patient was estimated in USD (2018) over the 24‐week period. Results Of 868 patients included in the study and initiated on therapy, 482 (55.5%) were co‐infected with HIV. The common genotypes were 1 (74.1%) and 3 (22%). Overall, SVR was achieved in 831 of the 868 patients (95.7%). SVR in patients with hepatitis C alone and hepatitis C/HIV co‐infection was 98.4% and 93.6%, respectively. Adverse events were infrequent and usually mild. Using generic medication, cost per patient was estimated at US$680. Conclusion A standard dose of LDV and SOF, with ribavirin as per protocol, resulted in good outcomes for patients with both hepatitis C alone and co‐infected with hepatitis C/HIV. Program costs in Ukraine were modest using generic medication.
