Pierre Pradat1, Thomas Huleux2, François Raffi3,4, Pierre Delobel5,6,7, Marc-Antoine Valantin8,9,10, Isabelle Poizot-Martin11,12,13, Pascal Pugliese14, Jacques Reynes15,16, David Rey17, Bruno Hoen18,19,20, André Cabie21,22,23, Firouzé Bani-Sadr24,25, Antoine Cheret26,27, Claudine Duvivier28,29, Christine Jacomet30, Anne Fresard31, Laurent Hustache-Mathieu32, Laurent Cotte33,34. 1. Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon. 2. Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing. 3. Department of Infectious Diseases, Hotel-Dieu Hospital, Centre Hospitalier Universitaire de Nantes, Nantes. 4. INSERM CIC 1413, Nantes. 5. Department of Infectious Diseases, Centre Hospitalier Universitaire de Toulouse. 6. Université Toulouse III Paul Sabatier. 7. INSERM, UMR1043, Toulouse. 8. Department of Infectious Diseases, Pitié-Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris. 9. Sorbonne Universités, UPMC Université Paris 06. 10. INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris. 11. Service d'Immuno-hématologie clinique, APHM Hôpital Sainte-Marguerite, Marseille. 12. Aix-Marseille University. 13. INSERM U912 (SESSTIM), Marseille. 14. Department of Infectious Diseases, Hôpital l'Archet, Centre Hospitalier Universitaire de Nice, Nice. 15. Department of Infectious Diseases, Centre Hospitalier Universitaire de Montpellier. 16. UMI 233 INSERM U1175, Montpellier. 17. HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg. 18. Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, Centre Hospitalier Universitaire de Pointe-à-Pitre. 19. Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre. 20. INSERM CIC 1424, Pointe-à-Pitre. 21. Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort-de-France. 22. Université des Antilles EA4537, Fort-de-France. 23. INSERM CIC1424, Fort-de-France. 24. Department of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims. 25. Université de Reims Champagne-Ardenne, Faculté de médecine, EA-4684/SFR CAP-SANTE, Reims. 26. Department of Internal Medicine, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris. 27. Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris. 28. Department of Infectious Diseases, Centre d'Infectiologie Necker-Pasteur, Assistance Publique - Hôpitaux de Paris. 29. IHU Imagine, Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris. 30. Department of Infectious Diseases, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand. 31. Department of Infectious Diseases, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne. 32. Department of Infectious Diseases, Centre Hospitalier Régional Universitaire de Besançon, Besançon. 33. Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon. 34. INSERM U1052, Lyon, France.
Abstract
OBJECTIVE: High hepatitis C virus (HCV) treatment uptake combined with effective direct-acting antiviral-based regimens resulted in a dramatic decline of HCV infection in French people living with HIV (PLWH). We assessed the yearly incidence of new HCV infection in PLWH enrolled in the large French Dat'AIDS cohort from 2012 to 2016 with a specific focus on MSM. METHODS: The incidence of new HCV infection was determined yearly in HCV-negative PLWH with serological follow-up during 2012-2016. The incidence of HCV reinfection was determined in patients who were cured of a previous infection. RESULTS: Among 40 714 PLWH, HCV status was available in 38 217 (94%). A total of 5557 PLWH (15%) were HCV infected at first time-point, 82% of whom were cured of HCV by the end of 2016. Among 21 519 HCV-negative PLWH with serological follow-up (63 449 patient-years), 219 first HCV infections occurred (MSM: 188, others: 31). Similarly, among 3406 patients who were cured of a previous infection (10 602 patient-years), 73 reinfections occurred (MSM: 51, others: 22). From 2012 to 2016, the incidence of a first infection in MSM rose from 0.5 to 0.92% patient-years, whereas the incidence or reinfection remained stable (2.52-2.90% patient-years). CONCLUSION: Despite a high HCV treatment uptake and cure rate, the incidence of first HCV infection regularly increased in French HIV-positive MSM between 2012 and 2016. The incidence of reinfection fluctuated but remained constantly higher than the incidence of first infection, suggesting that a subgroup of MSM pursued high-risk practices following cure of a first infection.
OBJECTIVE:High hepatitis C virus (HCV) treatment uptake combined with effective direct-acting antiviral-based regimens resulted in a dramatic decline of HCV infection in French people living with HIV (PLWH). We assessed the yearly incidence of new HCV infection in PLWH enrolled in the large French Dat'AIDS cohort from 2012 to 2016 with a specific focus on MSM. METHODS: The incidence of new HCV infection was determined yearly in HCV-negative PLWH with serological follow-up during 2012-2016. The incidence of HCV reinfection was determined in patients who were cured of a previous infection. RESULTS: Among 40 714 PLWH, HCV status was available in 38 217 (94%). A total of 5557 PLWH (15%) were HCVinfected at first time-point, 82% of whom were cured of HCV by the end of 2016. Among 21 519 HCV-negative PLWH with serological follow-up (63 449 patient-years), 219 first HCV infections occurred (MSM: 188, others: 31). Similarly, among 3406 patients who were cured of a previous infection (10 602 patient-years), 73 reinfections occurred (MSM: 51, others: 22). From 2012 to 2016, the incidence of a first infection in MSM rose from 0.5 to 0.92% patient-years, whereas the incidence or reinfection remained stable (2.52-2.90% patient-years). CONCLUSION: Despite a high HCV treatment uptake and cure rate, the incidence of first HCV infection regularly increased in French HIV-positive MSM between 2012 and 2016. The incidence of reinfection fluctuated but remained constantly higher than the incidence of first infection, suggesting that a subgroup of MSM pursued high-risk practices following cure of a first infection.
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