{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T17:40:11Z","timestamp":1754070011990,"version":"3.41.2"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Here, we assess the efficacy and safety of direct antiviral agents (DAAs) in a real-world cohort of co-infected individuals, and evaluate the consistency between clinical practice and guideline recommendations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Multicenter, prospective cohort study of HIV\/HCV co-infected patients followed-up in nine sites in Spain. All patients with detectable HCV-RNA naive to second-generation DAAs were enrolled. The primary endpoint was the assessment of sustained virological response at week 12 (SVR12). We performed intention-to-treat (ITT), per-protocol (PP), and multivariable analyses to identify factors associated with therapeutic failure. We compared the DAAs we administered to available guideline recommendations. Schemes not perfectly adjusted to the recommendations were defined as sub-optimal.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Overall, 316 patients (82.1% male) received a total of 330 treatments. Of these, 43.9% were cirrhotic and 40.6% were treatment-experienced. In the ITT and PP analyses, SVR12 was achieved in 90.9% [95% confidence interval (CI) 87.3\u201393.6] and 93.7% (95% CI 90.5\u201395.6), respectively. Only alcohol abuse [odds ratio (OR): 0.33; 95% CI 0.138\u20130.789, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.013] and a higher basal bilirubin level (OR: 0.595; 95% CI 0.416\u20130.851, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.004) were independently associated to therapeutic failure. A progressive decrease in the proportion of sub-optimal treatments was observed over time, from 75% in 2014 to 0% in 2018. Being treated with a sub-optimal regimen was not associated with failure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Despite numerous difficulties in treatment access and in adaptation to the changing guidelines, we detected no differences among the DAAs used, nor did we detect a lower efficacy when the chosen treatment was not optimal.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/meg.0000000000002012","type":"journal-article","created":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T15:03:11Z","timestamp":1606662191000},"page":"279-287","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Impact of interferon-free therapies in HIV\/HCV co-infected patients on real clinical practice: results from a multicenter region-wide cohort study (2014\u20132018)"],"prefix":"10.1097","volume":"32","author":[{"given":"David","family":"Rial-Crestelo","sequence":"first","affiliation":[{"name":"Hospital Universitario 12 de Octubre, HIV Unit, Madrid"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Antonia","family":"Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Hospital Virgen de la Salud, Toledo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Gonz\u00e1lez-Gasca","sequence":"additional","affiliation":[{"name":"Hospital General, Ciudad Real, Ciudad Real"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paloma","family":"Geijo-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital General Virgen de la Luz, Cuenca"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Mart\u00ednez-Alfaro","sequence":"additional","affiliation":[{"name":"Hospital General Universitario de Albacete, Albacete"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ram\u00f3n","family":"Barber\u00e1","sequence":"additional","affiliation":[{"name":"Hospital General la Mancha Centro, Ciudad Real"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Yzusqui","sequence":"additional","affiliation":[{"name":"Hospital Nuestra Se\u00f1ora del Prado, Toledo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Casallo","sequence":"additional","affiliation":[{"name":"Hospital Nuestra Se\u00f1ora del Prado, Toledo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital General de Villarrobledo, Albacete"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanza","family":"Mu\u00f1oz Hornero","sequence":"additional","affiliation":[{"name":"Hospital de Santa B\u00e1rbara, Puertollano, Ciudad Real"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Espinosa-Gimeno","sequence":"additional","affiliation":[{"name":"Hospital Universitario, Guadalajara, Guadalajara, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Torralba","sequence":"additional","affiliation":[{"name":"Hospital Universitario, Guadalajara, Guadalajara, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"R1-20250801","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1097\/QAD.0000000000001465","article-title":"Similar effectiveness of direct-acting antiviral against hepatitis C virus in patients with and without HIV infection.","volume":"31","author":"Montes","year":"2017","journal-title":"AIDS"},{"key":"R2-20250801","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1093\/cid\/civ1222","article-title":"How generalizable are the 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