Anne Boerekamps1, Guido E van den Berk2, Fanny N Lauw3, Eliane M Leyten4, Marjo E van Kasteren5, Arne van Eeden6, Dirk Posthouwer7, Mark A Claassen8, Anton S Dofferhoff9, Dominique W M Verhagen10, Wouter F Bierman11, Kamilla D Lettinga12, Frank P Kroon13, Corine E Delsing14, Paul H Groeneveld15, Robert Soetekouw16, Edgar J Peters17, Sebastiaan J Hullegie1, Stephanie Popping18, David A M C van de Vijver18, Charles A Boucher18, Joop E Arends19, Bart J Rijnders1. 1. Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam. 2. Department of Internal Medicine and Infectious Diseases, OLVG Oost. 3. Department of Internal Medicine and Infectious Diseases, Slotervaart MC, Amsterdam. 4. Department of Internal Medicine and Infectious Diseases, MC Haaglanden, Den Haag. 5. Department of Internal Medicine and Infectious Diseases, Elisabeth-TweeSteden Ziekenhuis, Tilburg. 6. Department of Internal Medicine and Infectious Diseases, DC Klinieken, Amsterdam. 7. Department of Internal Medicine and Infectious Diseases, Maastricht Universitair Medisch Centrum. 8. Department of Internal Medicine and Infectious Diseases, Rijnstate Ziekenhuis, Arnhem. 9. Department of Internal Medicine and Infectious Diseases, Radboud Universitair Medisch Centrum, Nijmegen. 10. Department of Internal Medicine and Infectious Diseases, MC Jan van Goyen, Amsterdam. 11. Department of Internal Medicine and Infectious Diseases, Universitair Medisch Centrum Groningen. 12. Department of Internal Medicine and Infectious Diseases, OLVG West, Amsterdam. 13. Department of Internal Medicine and Infectious Diseases, Leids Universitair Medisch Centrum, Leiden. 14. Department of Internal Medicine and Infectious Diseases, Medisch Spectrum Twente, Enschede. 15. Department of Internal Medicine and Infectious Diseases, Isala Ziekenhuis, Zwolle. 16. Department of Internal Medicine and Infectious Diseases, Spaarne Gasthuis, Haarlem. 17. Department of Internal Medicine and Infectious Diseases, VU Medisch Centrum, Amsterdam. 18. Department of Virology, Viroscience Lab, Erasmus MC, Rotterdam. 19. Department of Internal Medicine and Infectious Diseases, Universitair Medisch Centrum Utrecht, the Netherlands.
Abstract
Background: Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections. Methods: Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years. Results: The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI, .35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation. Conclusions: Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.
Background: Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCVpatients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections. Methods: Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years. Results: The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI, .35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation. Conclusions: Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.
Authors: Evan Gorstein; Marianne Martinello; Alexander Churkin; Swikriti Dasgupta; Kevin Walsh; Tanya L Applegate; David Yardeni; Ohad Etzion; Susan L Uprichard; Danny Barash; Scott J Cotler; Gail V Matthews; Harel Dahari Journal: Antiviral Res Date: 2020-06-25 Impact factor: 5.970
Authors: Shashi N Kapadia; Carrie D Johnston; Kristen M Marks; Bruce R Schackman; Erika G Martin Journal: J Public Health Manag Pract Date: 2019 May/Jun
Authors: Natasha K Martin; Klaus Jansen; Matthias An der Heiden; Christoph Boesecke; Anders Boyd; Knud Schewe; Axel Baumgarten; Thomas Lutz; Stefan Christensen; Alexander Thielen; Stefan Mauss; Jürgen K Rockstroh; Britt Skaathun; Patrick Ingiliz Journal: J Infect Dis Date: 2019-10-08 Impact factor: 5.226
Authors: Arun Rajasekaran; Ricardo A Franco; Edgar T Overton; Brendan M McGuire; Graham C Towns; Jayme E Locke; Deirdre L Sawinski; Emmy K Bell Journal: Kidney Int Rep Date: 2021-04-25
Authors: Maria A Corcorran; Natasha Ludwig-Baron; Debbie M Cheng; Dmitry Lioznov; Natalia Gnatienko; Gregory Patts; Kaku So-Armah; Elena Blokhina; Sally Bendiks; Evgeny Krupitsky; Jeffrey H Samet; Judith I Tsui Journal: AIDS Behav Date: 2021-03-17