Marianne Martinello1,2,3, Jasmine Yee1, Sofia R Bartlett1, Phillip Read4, David Baker5, Jeffrey J Post6,7,8, Robert Finlayson9, Mark Bloch10, Joseph Doyle11, David Shaw12, Margaret Hellard11,13, Kathy Petoumenos1, Lanni Lin1, Philippa Marks1, Tanya Applegate1, Gregory J Dore1,2, Gail V Matthews1,2. 1. The Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia. 2. St Vincent's Hospital, Sydney, New South Wales, Australia. 3. Blacktown Mt Druitt Hospital, Blacktown, New South Wales, Australia. 4. Kirketon Road Clinic, Sydney, New South Wales, Australia. 5. East Sydney Doctors, Sydney, New South Wales, Australia. 6. The Albion Centre, Sydney, New South Wales, Australia. 7. Prince of Wales Hospital, Sydney, New South Wales, Australia. 8. Prince of Wales Clinical School, University of New South Wales Sydney, Sydney, New South Wales, Australia. 9. Taylor Square Private Clinic, Sydney, New South Wales, Australia. 10. Holdsworth House Medical Practice, Sydney, New South Wales, Australia. 11. Burnet Institute, Melbourne, Victoria, Australia. 12. Royal Adelaide Hospital, Adelaide, South Australia, Australia. 13. Alfred Hospital, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Microelimination of hepatitis C virus (HCV) among people living with human immunodeficiency virus (HIV) may be feasible in Australia, given unrestricted access to direct-acting antiviral (DAA) therapy from 2016. Our aim was to evaluate progress towards elimination goals within HIV/HCV-coinfected adults in Australia following universal DAA access. METHODS: The CEASE prospective cohort study enrolled adults with HIV/HCV, irrespective of viremic status, from 14 primary and tertiary clinics in Australia. Annual and cumulative HCV treatment uptake, outcome, and HCV RNA prevalence were evaluated, with follow-up through May 2018 (median follow-up, 2.63 years). Factors associated with DAA uptake were analyzed. RESULTS: Between July 2014 and March 2017, 402 participants who were HIV/HCV antibody positive were enrolled (95% male [80% gay and bisexual men,], 13% cirrhosis, 80% history of injecting drug use [39% currently injecting]). Following universal DAA access, annual HCV treatment uptake in those eligible increased from 7% and 11% per year in 2014 and 2015, respectively, to 80% in 2016. By 2018, cumulative HCV treatment uptake in those ever eligible for treatment was 91% (336/371). HCV viremic prevalence declined from 82% (95% CI, 78-86%) in 2014 to 8% (95% CI, 6-12%) in 2018. Reinfection was reported in only 5 participants for a reinfection incidence of 0.81 per 100 person-years (95% CI, 0.34-1.94). CONCLUSIONS: High uptake and effectiveness of unrestricted DAA therapy in Australia have permitted rapid treatment scale-up, with a dramatic reduction in HCV infection burden and low reinfection rate among people living with HIV, suggesting that microelimination is feasible. CLINICAL TRIALS REGISTRATION: NCT02102451.
BACKGROUND: Microelimination of hepatitis C virus (HCV) among people living with human immunodeficiency virus (HIV) may be feasible in Australia, given unrestricted access to direct-acting antiviral (DAA) therapy from 2016. Our aim was to evaluate progress towards elimination goals within HIV/HCV-coinfected adults in Australia following universal DAA access. METHODS: The CEASE prospective cohort study enrolled adults with HIV/HCV, irrespective of viremic status, from 14 primary and tertiary clinics in Australia. Annual and cumulative HCV treatment uptake, outcome, and HCV RNA prevalence were evaluated, with follow-up through May 2018 (median follow-up, 2.63 years). Factors associated with DAA uptake were analyzed. RESULTS: Between July 2014 and March 2017, 402 participants who were HIV/HCV antibody positive were enrolled (95% male [80% gay and bisexual men,], 13% cirrhosis, 80% history of injecting drug use [39% currently injecting]). Following universal DAA access, annual HCV treatment uptake in those eligible increased from 7% and 11% per year in 2014 and 2015, respectively, to 80% in 2016. By 2018, cumulative HCV treatment uptake in those ever eligible for treatment was 91% (336/371). HCV viremic prevalence declined from 82% (95% CI, 78-86%) in 2014 to 8% (95% CI, 6-12%) in 2018. Reinfection was reported in only 5 participants for a reinfection incidence of 0.81 per 100 person-years (95% CI, 0.34-1.94). CONCLUSIONS: High uptake and effectiveness of unrestricted DAA therapy in Australia have permitted rapid treatment scale-up, with a dramatic reduction in HCV infection burden and low reinfection rate among people living with HIV, suggesting that microelimination is feasible. CLINICAL TRIALS REGISTRATION: NCT02102451.
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: David Ortiz-Paredes; Afia Amoako; Taline Ekmekjian; Kim Engler; Bertrand Lebouché; Marina B Klein Journal: Front Public Health Date: 2022-06-24
Authors: Sofia R Bartlett; Andrey Verich; Joanne Carson; Samira Hosseini-Hooshyar; Phillip Read; David Baker; Jeffrey J Post; Robert Finlayson; Mark Bloch; Joseph S Doyle; David Shaw; Margaret Hellard; Maria Martinez; Philippa Marks; Gregory J Dore; Gail V Matthews; Tanya Applegate; Marianne Martinello Journal: Health Sci Rep Date: 2022-08-18
Authors: Arpan A Patel; Aileen Bui; Eian Prohl; Debika Bhattacharya; Su Wang; Andrea D Branch; Ponni V Perumalswami Journal: Hepatol Commun Date: 2020-12-07
Authors: Jasmine Yee; Joanne M Carson; Behzad Hajarizadeh; Joshua Hanson; James O'Beirne; David Iser; Phillip Read; Anne Balcomb; Joseph S Doyle; Jane Davies; Marianne Martinello; Philiipa Marks; Gregory J Dore; Gail V Matthews Journal: Hepatol Commun Date: 2021-11-02