David C Boettiger1, Luisa Salazar-Vizcaya2, Gregory J Dore1, Richard T Gray1, Matthew G Law1, Denton Callander1, Toby Lea3,4, Andri Rauch2, Gail V Matthews1. 1. Kirby Institute, University of New South Wales Sydney, Australia. 2. Department of Infectious Diseases, Bern University Hospital, University of Bern, Inselpital, Switzerland. 3. Centre for Social Research in Health, University of New South Wales Sydney, Australia. 4. German Institute for Addiction and Prevention Research, Catholic University of Applied Sciences, Cologne.
Abstract
BACKGROUND: Human immunodeficiency virus (HIV)-positive gay and bisexual men (GBM) in Australia are well engaged in care. The World Health Organization's (WHO) hepatitis C virus (HCV) elimination target of an 80% reduction in incidence by 2030 may be reachable ahead of time in this population. METHODS: We predicted the effect of treatment and behavioral changes on HCV incidence among HIV-positive GBM up to 2025 using a HCV transmission model parameterized with Australian data. We assessed the impact of changes in behavior that facilitate HCV transmission in the context of different rates of direct-acting antiviral (DAA) use. RESULTS: HCV incidence in our model increased from 0.7 per 100 person-years in 2000 to 2.5 per 100 person-years in 2016 and had the same trajectory as previously reported clinical data. If the proportion of eligible (HCV RNA positive) patients using DAAs stays at 65% per year between 2016 and 2025, with high-risk sexual behavior and injecting drug use remaining at current levels, HCV incidence would drop to 0.4 per 100 person-years (85% decline from 2016). In the same treatment scenario but with substantial increases in risk behavior, HCV incidence would drop to 0.6 per 100 person-years (76% decline). If the proportion of eligible patients using DAAs dropped from 65% per year in 2016 to 20% per year in 2025 and risk behavior did not change, HCV incidence would drop to 0.7 per 100 person-years (70% reduction). CONCLUSIONS: Reaching the WHO HCV elimination target by 2025 among HIV-positive GBM in Australia is achievable.
BACKGROUND: Human immunodeficiency virus (HIV)-positive gay and bisexual men (GBM) in Australia are well engaged in care. The World Health Organization's (WHO) hepatitis C virus (HCV) elimination target of an 80% reduction in incidence by 2030 may be reachable ahead of time in this population. METHODS: We predicted the effect of treatment and behavioral changes on HCV incidence among HIV-positive GBM up to 2025 using a HCV transmission model parameterized with Australian data. We assessed the impact of changes in behavior that facilitate HCV transmission in the context of different rates of direct-acting antiviral (DAA) use. RESULTS:HCV incidence in our model increased from 0.7 per 100 person-years in 2000 to 2.5 per 100 person-years in 2016 and had the same trajectory as previously reported clinical data. If the proportion of eligible (HCV RNA positive) patients using DAAs stays at 65% per year between 2016 and 2025, with high-risk sexual behavior and injecting drug use remaining at current levels, HCV incidence would drop to 0.4 per 100 person-years (85% decline from 2016). In the same treatment scenario but with substantial increases in risk behavior, HCV incidence would drop to 0.6 per 100 person-years (76% decline). If the proportion of eligible patients using DAAs dropped from 65% per year in 2016 to 20% per year in 2025 and risk behavior did not change, HCV incidence would drop to 0.7 per 100 person-years (70% reduction). CONCLUSIONS: Reaching the WHO HCV elimination target by 2025 among HIV-positive GBM in Australia is achievable.
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: Aldemir B Oliveira-Filho; Diego Wendel F Aires; Natalia S Cavalcante; Nairis Costa Raiol; Brenda Luena A Lisboa; Paula Cristina R Frade; Luana M da Costa; Luiz Marcelo L Pinheiro; Luiz Fernando A Machado; Luisa C Martins; Gláucia C Silva-Oliveira; João Renato R Pinho; Emil Kupek; José Alexandre R Lemos Journal: Pathogens Date: 2019-11-14