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Harney BL, Sacks-Davis R, van Santen DK, Traeger MW, Wilkinson AL, Asselin J, Fairley CK, Roth N, Bloch M, Matthews GV, Donovan B, Guy R, Stoové M, Hellard ME, Doyle JS. Hepatitis C virus reinfection incidence among gay and bisexual men with HIV in Australia from 2016 to 2020. Liver Int 2024; 44:1024-1031. [PMID: 38291946 DOI: 10.1111/liv.15841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/02/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND There is some concern that hepatitis C virus (HCV) reinfection might impact HCV micro-elimination efforts among gay and bisexual men (GBM) with HIV. However, there is a limited understanding of reinfection incidence in the context of unrestricted government-funded HCV treatment. We aimed to estimate HCV reinfection incidence among GBM with HIV in Australia from 2016 to 2020. METHODS Data were from 39 clinics participating in ACCESS, a sentinel surveillance network for blood borne viruses and sexually transmissible infections across Australia. GBM with HIV who had evidence of treatment or spontaneous clearance with at least one positive HCV RNA test, a subsequent negative HCV RNA test, and at least one additional HCV RNA test between 1st January 2016 and 31st December 2020 were eligible for inclusion. A new HCV RNA positive test and/or detectable viral load was defined as a reinfection. Generalised linear modelling was used to examine trends in reinfection. RESULTS Among 12 213 GBM with HIV who had at least one HCV test, 540 were included in the reinfection incidence analysis, of whom 38 (7%) had evidence of reinfection during the observation period. Over 1124 person-years of follow-up, the overall rate of reinfection was 3.4/100PY (95% CI 2.5-4.6). HCV reinfection incidence declined on average 30% per calendar year (Incidence Rate Ratio 0.70, 95% CI 0.54-0.91). CONCLUSION HCV reinfection incidence has declined among GBM with HIV in Australia since government-funded unrestricted DAAs were made available. Ongoing HCV RNA testing following cure and prompt treatment for anyone newly diagnosed is warranted to sustain this.
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Affiliation(s)
- Brendan L Harney
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Disease, Alfred Health & Monash University, Melbourne, Victoria, Australia
| | - Rachel Sacks-Davis
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Daniela K van Santen
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Michael W Traeger
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Anna L Wilkinson
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jason Asselin
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Norman Roth
- Prahran Market Clinic, Melbourne, Victoria, Australia
| | - Mark Bloch
- Holdsworth House Medical Practice, Sydney, New South Wales, Australia
| | - Gail V Matthews
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Basil Donovan
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca Guy
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Margaret E Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Disease, Alfred Health & Monash University, Melbourne, Victoria, Australia
- Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Disease, Alfred Health & Monash University, Melbourne, Victoria, Australia
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2
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Evans KN, Wortley PM, Gandhi A, Bradley H. Trends in Hepatitis C Virus and HIV Care Outcomes Among People With HIV in Georgia, United States, 2014-2019. Public Health Rep 2023:333549231205341. [PMID: 37924243 DOI: 10.1177/00333549231205341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVE If untreated, hepatitis C virus (HCV) leads to poor health outcomes, including liver disease and death, particularly among people with HIV (PWH). We describe trends over time in incidence rates of HCV diagnoses among PWH in the state of Georgia. METHODS We constructed a retrospective cohort of PWH in Georgia by using matched HIV and HCV case surveillance data from people diagnosed with HCV infection from January 1, 2014, through December 31, 2019. We calculated annual incidence rates per 1000 person-years and estimated trends over time in HCV diagnoses among the cohort of PWH by demographic characteristics and HIV care outcomes using Poisson regression analysis, with α = .05 considered significant. RESULTS From 2014 through 2019, among 49 530 PWH in Georgia, 1945 (3.9%) were diagnosed with HCV infection. During this period, overall incidence per 1000 person-years of newly diagnosed HCV infection among PWH decreased from 8.7 to 4.5 (P for trend < .001). However, from 2014 through 2019, the annual incidence rates of PWH who were newly diagnosed with HCV infection increased from 4.6 to 7.1 (P for trend = .003) among people born from 1980 through 1989 and from 3.3 to 12.8 (P for trend < .001) among people born in 1990 or later. CONCLUSION Strategies are needed to increase prevention, diagnosis, and treatment of HIV/HCV coinfection, particularly among PWH born in 1980 and later. Routine linkage of state surveillance data can inform prioritization of PWH at highest risk of HCV infection.
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Affiliation(s)
- Kimberly N Evans
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Pascale M Wortley
- HIV/AIDS Epidemiology Section, Georgia Department of Public Health, Atlanta, GA, USA
| | - Ami Gandhi
- Viral Hepatitis Program, Georgia Department of Public Health, Atlanta, GA, USA
| | - Heather Bradley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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3
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Chen P, Simonetto DA, Paul S, Patel A. Health disparities experienced by sexual and gender minority individuals living with or at risk of chronic liver disease. Clin Liver Dis (Hoboken) 2023; 22:152-156. [PMID: 37908866 PMCID: PMC10615390 DOI: 10.1097/cld.0000000000000073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Phillip Chen
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Douglas A. Simonetto
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sonali Paul
- Department of Gastroenterology, Hepatology, and Nutrition, Center for Liver Diseases, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Arpan Patel
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Gastroenterology, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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4
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Tsai WC, Chiang HC, Chiu YC, Chien SC, Cheng PN, Chiu HC. Chronic Hepatitis C Virus Infection: An Ongoing Challenge in Screening and Treatment. Life (Basel) 2023; 13:1964. [PMID: 37895346 PMCID: PMC10608250 DOI: 10.3390/life13101964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
With the advent of direct-acting antiviral agents (DAA) in the recent few years, hepatitis C virus (HCV) infection has become a curable infectious disease. Successful clearance of HCV could lead to improvement of both hepatic and extrahepatic outcomes, such as complications of cirrhosis, hepatocellular carcinoma, cardiovascular diseases, and incident diabetes. However, challenges persist in reaching the HCV elimination goals of the World Health Organization by 2030. Among these challenges are identifying those already infected or undiagnosed subjects, re-linking to the care of known but untreated HCV-infected subjects, and developing strategies to enhance treatment rates and compliance in specific or high-risk populations. In addition, issues of post-DAA viral clearance, including avoiding or preventing reinfection in high-risk populations and surveillance of hepatocellular carcinoma, are important to consolidate the treatment's short- and long-term efficacies. In the current DAA era, treatment is the most effective prevention strategy not only in its excellent efficacy and safety but also in preventing HCV spread. All of the surveillance or measures should center on DAA treatment in clinical practice.
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Affiliation(s)
| | | | | | | | - Pin-Nan Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (W.-C.T.); (H.-C.C.); (Y.-C.C.); (S.-C.C.)
| | - Hung-Chih Chiu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (W.-C.T.); (H.-C.C.); (Y.-C.C.); (S.-C.C.)
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5
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Vergara-Samur H, Martínez-Vernaza S, De la Hoz A, Barahona-Correa J, Ortiz JP, Gualtero-Trujillo S, Rumbo-Romero J, Salazar LM, Suárez Quintero Y, Valderrama-Beltrán S. Comparative outcomes of direct-acting antiviral treatment in patients with HIV-Hepatitis C co-infection: insights from a single center experience in Colombia. LE INFEZIONI IN MEDICINA 2023; 31:374-383. [PMID: 37701377 PMCID: PMC10495049 DOI: 10.53854/liim-3103-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/26/2023] [Indexed: 09/14/2023]
Abstract
Background Direct-acting antivirals (DAA) were introduced to Latin America with the aim of eliminating hepatitis C (HCV) in the region. There are scarce data on the outcomes of people living with HIV and HCV treated with these medications in Colombia. This study compares the outcomes of patients with HIV-HCV co-infection and HCV mono-infection treated with DAAs. Methods Retrospective observational study including patients ≥18 years old with HCV infection treated with DAAs from August 2017 to December 2019 in a comprehensive center in Colombia. The main outcome was sustained virologic response (SVR). Secondary outcomes included reinfection, relapse and adverse events. Results We included 223 individuals with HCV treated with DAAs; 142 (63.6%) individuals were mono-infected and 81 (36.3%) co-infected. Genotypes 1b (49.7%) and 4 (33.9%) were the most common. Overall SVR after DAA treatment was 96.8%. Relapse rate was 2.24%, reinfection rate was 6.28% and adverse events occurred in 27.8% of cases. SVR was comparable in patients with co- and mono-infection (95% vs 97.8%, p=0.245). Conclusion DAA were effective in mono-infected (HCV) and co-infected (HCV/HIV) patients and reinfection was high in this last group.
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Affiliation(s)
- Hernán Vergara-Samur
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Samuel Martínez-Vernaza
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Alejandro De la Hoz
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
- Department of Internal Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, United States of America
| | | | - Juan Pablo Ortiz
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Sandra Gualtero-Trujillo
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - José Rumbo-Romero
- Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis Miguel Salazar
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Yanette Suárez Quintero
- Division of Gastroenterology, Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Sandra Valderrama-Beltrán
- Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá, Colombia
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6
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Cheema JS, Mathews WC, Wynn A, Bamford LB, Torriani FJ, Hill LA, Rajagopal AV, Yin J, Jain S, Garfein RS, Cachay ER, Martin NK. Hepatitis C Virus Micro-elimination Among People With HIV in San Diego: Are We on Track? Open Forum Infect Dis 2023; 10:ofad153. [PMID: 37065984 PMCID: PMC10099471 DOI: 10.1093/ofid/ofad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/20/2023] [Indexed: 04/18/2023] Open
Abstract
Background Rising incidence of hepatitis C virus (HCV) among people with HIV (PWH) in San Diego County (SDC) was reported. In 2018, the University of California San Diego (UCSD) launched a micro-elimination initiative among PWH, and in 2020 SDC launched an initiative to reduce HCV incidence by 80% across 2015-2030. We model the impact of observed treatment scale-up on HCV micro-elimination among PWH in SDC. Methods A model of HCV transmission among people who inject drugs (PWID) and men who have sex with men (MSM) was calibrated to SDC. The model was additionally stratified by age, gender, and HIV status. The model was calibrated to HCV viremia prevalence among PWH in 2010, 2018, and 2021 (42.1%, 18.5%, and 8.5%, respectively), and HCV seroprevalence among PWID aged 18-39 years, MSM, and MSM with HIV in 2015. We simulate treatment among PWH, weighted by UCSD Owen Clinic (reaching 26% of HCV-infected PWH) and non-UCSD treatment, calibrated to achieve the observed HCV viremia prevalence. We simulated HCV incidence with observed and further treatment scale-up (+/- risk reductions) among PWH. Results Observed treatment scale-up from 2018 to 2021 will reduce HCV incidence among PWH in SDC from a mean of 429 infections/year in 2015 to 159 infections/year in 2030. County-wide scale-up to the maximum treatment rate achieved at UCSD Owen Clinic (in 2021) will reduce incidence by 69%, missing the 80% incidence reduction target by 2030 unless accompanied by behavioral risk reductions. Conclusions As SDC progresses toward HCV micro-elimination among PWH, a comprehensive treatment and risk reduction approach is necessary to reach 2030 targets.
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Affiliation(s)
- Jaskaran S Cheema
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - William C Mathews
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Adriane Wynn
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Laura B Bamford
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Francesca J Torriani
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Lucas A Hill
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Amutha V Rajagopal
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Jeffrey Yin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Sonia Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California, USA
| | - Richard S Garfein
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Edward R Cachay
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
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7
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Marshall AD, Martinello M, Treloar C, Matthews GV. Perceptions of hepatitis C treatment and reinfection risk among HIV-positive men who have sex with men and engage in high risk behaviours for hepatitis C transmission: The CEASE qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103828. [PMID: 35994937 DOI: 10.1016/j.drugpo.2022.103828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Globally, treatment uptake for hepatitis C virus (HCV) infection among HIV-HCV coinfected men who have sex with men (MSM) has substantially increased since the advent of interferon-free direct-acting antivirals (DAA). However, HIV-positive MSM who engage in high risk behaviours are at an increased risk of HCV reinfection post-treatment. The aim of this study was to investigate perceptions of HCV diagnosis, treatment and reinfection risk among HCV-HIV coinfected MSM who engage in drug use and/or high risk sexual behavior in Sydney, Australia. METHODS Participants were recruited from the Control and Elimination within AuStralia of HEpatitis C from people living with HIV (CEASE) cohort (n=402) who reported engaging in drug use and/or high risk sexual behavior for transmission of HCV infection. Participants were interviewed about their perceptions of HCV diagnosis, treatment, and reinfection risk. Interview data were transcribed, coded, and analyzed thematically. RESULTS Of 33 participants interviewed (mean age 49 years), many participants were 'shocked' by their HCV diagnosis. Participants who believed they acquired HCV infection through sexual exposure felt it was important that their healthcare practitioner agreed with their perspective to mitigate stigmatizing experiences. Overall, participants expressed high satisfaction with their treatment experience due to long-standing therapeutic relationships with their HIV physician. Many participants expressed knowledge of how to prevent HCV reinfection from injection drug use, yet other than condom usage, most were unsure how to reduce high risk sexual activity with such discussions occurring less frequently with healthcare practitioners. CONCLUSION Findings indicate that MSM who engage in drug use and high risk sexual activity would benefit from additional education on reducing reinfection risk through sexual activity and services to reduce substance use, if requested.
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Affiliation(s)
- Alison D Marshall
- The Kirby Institute, UNSW Sydney, Sydney, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
| | | | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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8
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Wan Z, Sun P, Dzakah EE, Huang L, Shuai P, Liu Y. Reinfection rate of hepatitis C in HIV-1 positive men who have sex with men: A systematic review and meta-analysis. Front Public Health 2022; 10:855989. [PMID: 35968434 PMCID: PMC9372531 DOI: 10.3389/fpubh.2022.855989] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/07/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose A reduction of 80% in new Hepatitis C virus (HCV) infection is expected by 2030. However, high HCV reinfection rates have been reported among the high-risk population. This meta-analysis aimed to assess the HCV reinfection rate after successful treatment of HIV-1 coinfected MSM populations. Methods Bibliographic databases were searched and a random-effect model was utilized to calculate the pooled HCV reinfection rate. Sub-group and meta-regression were used to explore heterogeneity among selected studies. A funnel plot and Egger's regression test were performed to estimate the publication bias. Results Sixteen studies with 9,017.2 person-years (PY) follow-up were included. The overall HCV reinfection rate following successful treatment among HIV-1-infected MSM was 5.27/100 PY (95% CI, 3.98, 6.96). Lower reinfection rates were observed in developed parts of Europe (5.28/100 PY; 95% CI, 3.73, 6.84) and North America (3.92/100 PY; 95% CI, 1.67, 6.17). Reinfection rates among people with HCV test intervals of fewer than 6 months (7.59/100 PY; 95% CI: 5.15, 10.03) were significantly higher than those with more than 6 months test interval (2.88/100 PY; 95% CI: 2.26, 3.50), with an adjusted RR of 1.86 (95% CI, 1.06, 3.13). The adjusted study factors explained 91.03% the of studies' heterogeneity. Conclusion HCV reinfection rate was high in successfully treated MSM who were coinfected with HIV-1. A shorter HCV test interval may help to explore more HCV reinfections. HCV reinfection rate studies from HIV-1 coinfected MSM in underdeveloped countries are urgently needed. Meta registration PROSPERO: CRD42021285206, URL: https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Zhengwei Wan
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Sun
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Emmanuel Enoch Dzakah
- Department of Molecular Biology and Biotechnology, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Liping Huang
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ping Shuai
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Ping Shuai
| | - Yuping Liu
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Yuping Liu
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9
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Liu CH, Sun HY, Peng CY, Hsieh SM, Yang SS, Kao WY, Shih YL, Lin CL, Liu CJ, Sheng WH, Lo YC, Liu WC, Wu JH, Su TH, Tseng TC, Chen PJ, Hung CC, Kao JH. Hepatitis C virus reinfection in people living with human immunodeficiency virus in Taiwan after achieving sustained virologic response with antiviral treatment: the RECUR study. Open Forum Infect Dis 2022; 9:ofac348. [PMID: 35928504 PMCID: PMC9345411 DOI: 10.1093/ofid/ofac348] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Data on hepatitis C virus (HCV) reinfection in East Asian people living with human immunodeficiency virus (HIV) after treatment-induced sustained virologic response (SVR) are limited.
Methods
HIV/HCV-coinfected patients in Taiwan who achieved SVR12 with interferon (IFN) or direct-acting antivirals (DAAs) between 2005 and 2021 underwent HCV RNA measurements at SVR24 and then biannually. HCV reinfection was defined as the detection of different HCV strains beyond SVR12. HIV-negative, low-risk individuals with SVR12 served as reference patients. Crude reinfection rates and secular trends were assessed. Multivariate Cox regression analysis was performed to identify baseline factors associated with HCV reinfection.
Results
A total of 216 HIV-positive and 1589 reference patients were recruited with median follow-up durations of 3.0 and 6.0 years. During a total of 772 person-years of follow-up (PYFU), the HCV reinfection rate in HIV-positive patients was 4.02 per 100 PYFU (95% confidence interval [CI]: 2.85-5.65), while the HCV reinfection rate in reference patients was 0.14 per 100 PYFU (95% CI: 0.09-0.23) during 10862 PYFU. HIV-positive patients had a higher risk of HCV reinfection than reference patients (hazard ratio [HR]: 17.63; 95% CI: 7.10-43.80, p < 0.001). No baseline factors were predictive of HCV reinfection in HIV-positive patients. The incidence of HCV reinfection in HIV-positive patients increased after 2015 when DAAs were available in Taiwan.
Conclusions
The risk of HCV reinfection remains high in HIV/HCV-coinfected patients with treatment-induced SVR12. In addition to mass screening and treatment scale-up, strategies to reduce reinfection are needed for HCV microelimination in HIV-positive patients in Taiwan.
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Affiliation(s)
- Chen Hua Liu
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
- Department of Internal Medicine, National Taiwan University Hospital , Yun-Lin Branch, Yunlin , Taiwan
| | - Hsin Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
| | - Cheng Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital , Taichung , Taiwan
- School of Medicine, China Medical University , Taichung , Taiwan
| | - Szu Min Hsieh
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
| | - Sheng Shun Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital , Taichung , Taiwan
- School of Medicine, Chung Shan Medical University , Taichung , Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University , Taichung , Taiwan
| | - Wei Yu Kao
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital , Taipei , Taiwan
- School of Medicine, Taipei Medical University College of Medicine , Taipei , Taiwan
- Graduate Institute of Clinical Medicine, Taipei Medical University College of Medicine , Taipei , Taiwan
| | - Yu Lueng Shih
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan
| | - Chih Lin Lin
- Department of Gastroenterology, Taipei City Hospital , Ren-Ai Branch, Taipei , Taiwan
| | - Chun Jen Liu
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine , Taipei , Taiwan
| | - Wang Hui Sheng
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
| | - Yi Chun Lo
- Centers for Disease Control , Taipei , Taiwan
| | - Wen Chun Liu
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
| | - Jo Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California , San Diego, California , USA
| | - Tung Hung Su
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
| | - Tai Chung Tseng
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
- Department of Medical Research, National Taiwan University Hospital , Taipei , Taiwan
| | - Pei Jer Chen
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine , Taipei , Taiwan
| | - Chien Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine , Taipei , Taiwan
| | - Jia Horng Kao
- Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan
- Hepatitis Research Center, National Taiwan University Hospital , Taipei , Taiwan
- Department of Medical Research, National Taiwan University Hospital , Taipei , Taiwan
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10
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Hassan A, Agustin HGS, Burke L, Kofron R, Corado K, Bolan R, Landovitz RJ, Dubé MP, Morris SR. Low incidence and prevalence of hepatitis C in two cohorts of HIV pre-exposure prophylaxis adherence interventions in men who have sex with men in Southern California. J Viral Hepat 2022; 29:529-535. [PMID: 35357767 PMCID: PMC9908082 DOI: 10.1111/jvh.13678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 02/02/2023]
Abstract
HIV pre-exposure prophylaxis (PrEP) has been associated with incident hepatitis C virus (HCV) infection in men who have sex with men (MSM) due to decreased condom use. We examined rates of HCV among MSM and transgender women at high-risk of HIV on PrEP in Southern California using data from two trials (NCT01761643 and NCT01781806). Five of 599 participants (0.84%, 95% CI, 0.27-1.93) had HCV antibodies detected at entry. Factors associated with HCV seropositivity included being older (p = .002) and lower education level (p < .001). HCV-positive participants had no reported cases of sexually transmitted infection (rectal, urethral or pharyngeal gonorrhoea and/or chlamydia) at entry while HCV-negative participants had a prevalence of 18% (95% CI, 15%-21%). There were no significant differences in substance use and sexual risk behaviour between HCV-positive and HCV-negative participants 1-3 months prior to entry. Among early PrEP adopters, incident HCV did not occur despite ongoing condomless intercourse. Screening intervals for HCV in MSM on PrEP should be led by a risk behaviour assessment.
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Affiliation(s)
- Adiba Hassan
- Department of Medicine, University of California, San Diego, CA, USA,Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, CA, USA * research was conducted at Department of Medicine, University of California, San Diego, CA, USA
| | | | - Leah Burke
- Department of Medicine, University of California, San Diego, CA, USA
| | - Ryan Kofron
- Department of Medicine, University of California, Los Angeles, CA, USA
| | - Katya Corado
- Division of HIV Medicine, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | | | - Michael P Dubé
- Department of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sheldon R Morris
- Department of Medicine, University of California, San Diego, CA, USA
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11
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Hosseini-Hooshyar S, Hajarizadeh B, Bajis S, Law M, Janjua NZ, Fierer DS, Chromy D, Rockstroh JK, Martin TCS, Ingiliz P, Hung CC, Dore GJ, Martinello M, Matthews GV. Risk of hepatitis C reinfection following successful therapy among people living with HIV: a global systematic review, meta-analysis, and meta-regression. THE LANCET HIV 2022; 9:e414-e427. [DOI: 10.1016/s2352-3018(22)00077-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/21/2022] [Accepted: 03/14/2022] [Indexed: 12/17/2022]
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12
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Chromy D, Bauer DJM, Simbrunner B, Jachs M, Hartl L, Schwabl P, Schwarz C, Rieger A, Grabmeier‐Pfistershammer K, Trauner M, Ferenci P, Mandorfer M, Gschwantler M, Reiberger T. The 'Viennese epidemic' of acute HCV in the era of direct-acting antivirals. J Viral Hepat 2022; 29:385-394. [PMID: 35274399 PMCID: PMC9415118 DOI: 10.1111/jvh.13665] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/15/2022] [Indexed: 01/01/2023]
Abstract
The recently reported epidemic of acute hepatitis C virus (HCV) infections -observed predominantly among men who have sex with men (MSM)-may now decline due to wide availability of direct-acting antivirals (DAAs). This study aimed to investigate the current trends of acute hepatitis C in Vienna. Patients presenting with acute hepatitis C between 01/2007 and12/2020 at the Vienna General Hospital were retrospectively enrolled and followed after virologic clearance/eradication. The introduction of unrestricted DAA access after 09/17 defined the 'DAA era', as compared to the 'pre-DAA era' prior to 09/17. We identified 134 acute hepatitis C cases in 119 patients with a mean age of 39 ± 9 years at inclusion. The majority of patients were male (92%), HIV-positive (88%) and MSM (85%). In the DAA era, a history of prior chronic HCV infection at inclusion was found in 24% (11/46) compared to 7% (5/73) in the pre-DAA era (p = .012). The annual rate of acute hepatitis C cases increased in the DAA era (17.11 per year) compared to the pre-DAA era (7.76 per year). The DAA era included an AHC-genotype-2 cluster and more HIV-negative acute hepatitis C cases (0% (0/73) vs. 30% (14/46), p < .001). Patients were followed after spontaneous clearance or sustained virologic treatment response (SVR) for a total of 251.88 patient-years (median 1.39 years per patient). In the DAA era, we recorded 15 acute hepatitis C-reinfections - corresponding to an incidence rate of 5.96 (95% CI: 3.57-9.66) reinfections per 100-patient-years. We continue to observe a high incidence of acute hepatitis C in Vienna in the DAA era-primarily among HIV-positive MSM, but increasingly also in HIV-negative MSM.
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Affiliation(s)
- David Chromy
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria,Department of DermatologyMedical University of ViennaViennaAustria
| | - David J. M. Bauer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Benedikt Simbrunner
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Matthias Jachs
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Lukas Hartl
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Philipp Schwabl
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Caroline Schwarz
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria,Department of Internal Medicine IVWilhelminenspitalWiener Gesundheitsverbund (WiGeV) der Stadt WienViennaAustria
| | - Armin Rieger
- Vienna HIV & Liver Study GroupViennaAustria,Department of DermatologyMedical University of ViennaViennaAustria
| | - Katharina Grabmeier‐Pfistershammer
- Vienna HIV & Liver Study GroupViennaAustria,Center for Pathophysiology, Infectiology and ImmunologyInstitute of ImmunologyMedical University ViennaViennaAustria
| | - Michael Trauner
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Peter Ferenci
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Mattias Mandorfer
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
| | - Michael Gschwantler
- Vienna HIV & Liver Study GroupViennaAustria,Department of Internal Medicine IVWilhelminenspitalWiener Gesundheitsverbund (WiGeV) der Stadt WienViennaAustria
| | - Thomas Reiberger
- Division of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria,Vienna HIV & Liver Study GroupViennaAustria
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13
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Zheng Y, Ying M, Zhou Y, Lin Y, Ren J, Wu J. Global Burden and Changing Trend of Hepatitis C Virus Infection in HIV-Positive and HIV-Negative MSM: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:774793. [PMID: 34966758 PMCID: PMC8710739 DOI: 10.3389/fmed.2021.774793] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The disease burden of hepatitis C virus (HCV) infection in HIV-positive and HIV-negative men who have sex with men (MSM) is changing. We aim to provide an updated comprehensive estimate of HCV prevalence and incidence among the HIV-positive and HIV-negative MSM population at the country, regional, and global levels and their changing trends over time. Methods: PubMed, Embase, PsycINFO, CINAHL, and conference databases were searched and eligible records on the prevalence and incidence of HCV antibodies were selected and pooled via a random-effects model. Meta-regression was performed to demonstrate the association between the pooled rates and study year. Results: A total of 230 articles reporting 245 records from 51 countries with 445,883 participants and 704,249 follow-up person-years were included. The pooled prevalence of HCV in MSM was 5.9% (95% CI: 5.1-6.8), with substantial differences between countries and regions. Low- and lower-middle-income countries (12.3 and 7.0%) manifested a larger disease burden than high- and upper-middle-income countries (5.8 and 3.8%). HCV prevalence in HIV-positive MSM was substantially higher than in HIV-negative MSM (8.1 vs. 2.8%, p < 0.001). The pooled incidence of HCV was 8.6 (95% CI: 7.2-10.0) per 1,000 person-years, with an increasing trend over time, according to meta-regression (p < 0.05). Conclusion: Global HCV prevalence in MSM varies by region and HIV status. Behavior counseling and regular HCV monitoring are needed in HIV-positive subgroups and high-risk regions. Given the upward trend of HCV incidence and sexual risk behaviors, there is also a continued need to reinforce risk-reduction intervention. Systematic Review Registration: PROSPERO, identifier CRD42020211028; https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meike Ying
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuqing Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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14
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Wynn A, Tweeten S, McDonald E, Wooten W, Lucas K, Cyr CL, Hernandez M, Ramirez F, VanWormer C, Suckow S, Ramers CB, Martin NK. The estimated hepatitis C seroprevalence and key population sizes in San Diego in 2018. PLoS One 2021; 16:e0251635. [PMID: 34106932 PMCID: PMC8189442 DOI: 10.1371/journal.pone.0251635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/29/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The Eliminate Hepatitis C San Diego County Initiative was established to provide a roadmap to reduce new HCV infections by 80% and HCV-related deaths by 65% by 2030. An estimate of the burden of HCV infections in San Diego County is necessary to inform planning and evaluation efforts. Our analysis was designed to estimate the HCV burden in San Diego County in 2018. METHODS We synthesized data from the American Community Survey, Centers for Disease Control and Prevention, California Department of Public Health, Public Health Branch of California Correctional Health Care Services, San Diego Blood Bank, and published literature. Burden estimates were stratified by subgroup (people who inject drugs in the community [PWID], men who have sex with men in the community [MSM], general population in the community [stratified by age and sex], and incarcerated individuals). To account for parameter uncertainty, 100,000 parameter sets were sampled from each parameter's uncertainty distribution, and used to calculate the mean and 95% confidence interval estimates of the number of HCV seropositive adults in San Diego in 2018. FINDINGS We found there were 55,354 (95% CI: 25,411-93,329) adults with a history of HCV infection in San Diego County in 2018, corresponding to an HCV seroprevalence of 2.1% (95% CI: 1.1-3.4%). Over 40% of HCV infections were among the general population aged 55-74 and one-third were among PWID. CONCLUSION Our study found that the largest share of infections was among adults aged 55-74, indicating the importance of surveillance, prevention, testing, and linkages to care in this group to reduce mortality. Further, programs prioritizing PWID for increased HCV testing and linkage to care are important for reducing new HCV infections.
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Affiliation(s)
- Adriane Wynn
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
| | - Samantha Tweeten
- San Diego County Health and Human Services Agency, San Diego, CA, United States of America
| | - Eric McDonald
- San Diego County Health and Human Services Agency, San Diego, CA, United States of America
| | - Wilma Wooten
- San Diego County Health and Human Services Agency, San Diego, CA, United States of America
| | - Kimberley Lucas
- California Correctional Health Care Services, San Diego, CA, United States of America
| | - Cassandra L. Cyr
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
| | - Maricris Hernandez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
| | - Franchesca Ramirez
- Rady Children’s Hospital San Diego, San Diego, CA, United States of America
| | - Corey VanWormer
- San Diego Blood Bank, San Diego, CA, United States of America
| | - Scott Suckow
- American Liver Foundation Pacific Coast Division
| | - Christian B. Ramers
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, CA, United States of America
| | - Natasha K. Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States of America
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15
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Li J, Armon C, Palella FJ, Tedaldi E, Novak RM, Fuhrer J, Simoncini G, Carlson K, Buchacz K. Hepatitis C Virus Testing Among Men With Human Immunodeficiency Virus Who Have Sex With Men: Temporal Trends and Racial/Ethnic Disparities. Open Forum Infect Dis 2021; 8:ofaa645. [PMID: 33889655 DOI: 10.1093/ofid/ofaa645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background National guidelines recommend that sexually active people with human immunodeficiency virus (PWH) who are men who have sex with men (MSM) be tested for hepatitis C virus (HCV) infection at least annually. Hepatitis C virus testing rates vary by race/ethnicity in the general population, but limited data are available for PWH. Methods We analyzed medical records data from MSM in the HIV Outpatient Study at 9 human immunodeficiency virus (HIV) clinics from January 1, 2011 through December 31, 2019. We excluded observation time after documented past or current HCV infection. We evaluated HCV antibody testing in each calendar year among HCV-seronegative MSM, and we assessed testing correlates by generalized estimating equation analyses. Results Of 1829 eligible MSM who were PWH, 1174 (64.2%) were non-Hispanic/Latino white (NHW), 402 (22.0%) non-Hispanic black (NHB), 187 (10.2%) Hispanic/Latino, and 66 (3.6%) of other race/ethnicity. Most were ≥40 years old (68.9%), privately insured (64.5%), with CD4 cell count/mm3 (CD4) ≥350 (77.0%), and with HIV viral load <200 copies/mL (76.9%). During 2011-2019, 1205 (65.9%) had ≥1 HCV antibody test and average annual HCV percentage tested was 30.3% (from 33.8% for NHB to 28.5% for NHW; P < .001). Multivariable factors positively associated (P < .05) with HCV testing included more recent HIV diagnosis, public insurance, lower CD4, prior chlamydia, gonorrhea, syphilis, or hepatitis B virus diagnoses, and elevated liver enzyme levels, but not race/ethnicity. Conclusions Although we found no disparities by race/ethnicity in HCV testing, low overall HCV testing rates indicate suboptimal uptake of recommended HCV testing among MSM in HIV care.
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Affiliation(s)
- Jun Li
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carl Armon
- Cerner Corporation, Kansas City, Missouri, USA
| | - Frank J Palella
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ellen Tedaldi
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Richard M Novak
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Jack Fuhrer
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Gina Simoncini
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | | | - Kate Buchacz
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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16
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Adu PA, Rossi C, Binka M, Wong S, Wilton J, Wong J, Butt ZA, Bartlett S, Jeong D, Pearce M, Darvishian M, Yu A, Alvarez M, Velásquez García HA, Krajden M, Janjua NZ. HCV reinfection rates after cure or spontaneous clearance among HIV-infected and uninfected men who have sex with men. Liver Int 2021; 41:482-493. [PMID: 33305525 DOI: 10.1111/liv.14762] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 11/13/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV) reinfection among high-risk groups threatens HCV elimination goals. We assessed HCV reinfection rates among men who have sex with men (MSM) in British Columbia (BC), Canada. METHODS We used data from the BC Hepatitis Testers Cohort, which includes nearly 1.7 million individuals tested for HCV or HIV in BC. MSM who had either achieved sustained virologic response (SVR) after successful HCV treatment, or spontaneous clearance (SC) and had ≥1 subsequent HCV RNA measurement, were followed from the date of SVR or SC until the earliest of reinfection, death, or last HCV RNA measurement. Predictors of reinfection were identified by Cox proportional modelling. The earliest study start date was 6 November 1997 and latest end date was 13 April 2018. RESULTS Of 1349 HCV-positive MSM who met the inclusion criteria, 493 had SC while 856 achieved SVR. 349 (25.65%) had HIV coinfection. We identified 98 reinfections during 5203 person-years (PYs) yielding a reinfection rate of 1.88/100PYs. The reinfection rate among SC (2.74/100PYs) was more than twice that of those with SVR (1.03/100 PYs). Problematic alcohol use (aHR 1.73, 95% CI 1.003-2.92), injection drug use (aHR 2.60, 95% CI 1.57-4.29) and HIV coinfection (aHR 2.04, 95% CI 1.29-3.23) were associated with increased risk of HCV reinfection. Mental health counselling history (aHR 0.24, 95% CI 0.13-0.46) was associated with reduced HCV reinfection risk. CONCLUSIONS There is the need to engage MSM in harm reduction and prevention services following treatment to reduce reinfection risk.
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Affiliation(s)
- Prince A Adu
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carmine Rossi
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Analysis Group, Inc., Montreal, Quebec, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mawuena Binka
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - James Wilton
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Zahid A Butt
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Sofia Bartlett
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dahn Jeong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Margo Pearce
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Maryam Darvishian
- British Columbia Cancer Research Centre, Vancouver, British Columbia, Canada
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Maria Alvarez
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Ang LW, Choy CY, Ng OT, Leo YS, Wong CS. Hepatitis C virus infection in HIV-infected men in Singapore, 2006-2018: incidence and associated factors. Sex Health 2021; 18:221-231. [PMID: 34148565 DOI: 10.1071/sh20197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022]
Abstract
Background The epidemiology of hepatitis C virus (HCV) infection in people living with HIV has been evolving, with increasing evidence of permucosal (sexual) transmission identified predominantly in HIV-positive men who have sex with men (MSM). The aim of this study was to estimate the incidence rate and elucidate epidemiological factors associated with HCV infection among HIV-infected men in Singapore from 2006 to 2018. METHODS A retrospective cohort study was conducted using a clinical database maintained by the Clinical HIV Program at the National Centre for Infectious Diseases, Singapore. Factors associated with incident HCV infections were identified using Cox proportional hazards regression analyses. RESULTS Among 1348 HIV-infected male patients who were HCV seronegative at baseline, 64 (4.7%) subsequently tested positive for HCV, giving an incidence of 0.88 per 100 person-years of follow-up (PYFU) (95% confidence interval (CI) 0.69-1.13). The incidence rate of HCV seroconversion increased from 0.33 (95% CI 0.12-0.71) per 100 PYFU in 2010-2012 to 1.93 (95% CI 1.36-2.67) in 2016-2018. Independent factors associated with incident HCV infection were younger age groups at HIV diagnosis versus ≥45 years, HIV acquisition via MSM or via both sexual contact and intravenous drug use versus heterosexual transmission, HIV diagnosis in later periods versus 2006-2009, and recent syphilis acquisition. CONCLUSIONS An increasing trend of incident HCV infection was seen in HIV-infected men, particularly for MSM. Preventive and behavioural interventions should be targeted at HIV-infected individuals engaged in high-risk sexual behaviour.
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Affiliation(s)
- Li Wei Ang
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore; and Corresponding author.
| | - Chiaw Yee Choy
- Department of Infectious Diseases, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore
| | - Oon Tek Ng
- Department of Infectious Diseases, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore; and Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore; and Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, 308232, Singapore
| | - Yee Sin Leo
- Department of Infectious Diseases, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore; and Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore; and Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, 308232, Singapore; and Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, 117597, Singapore; and Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Chen Seong Wong
- Department of Infectious Diseases, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, 308442, Singapore; and Department of Infectious Diseases, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, Singapore; and Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, 308232, Singapore
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18
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Hill LA, Martin NK, Torriani FJ, Jain S, Qin H, Mathews WC, Cachay ER. Screening for Sexually Transmitted Infections During Hepatitis C Treatment to Predict Reinfection Among People With HIV. Open Forum Infect Dis 2020; 8:ofaa643. [PMID: 33553480 PMCID: PMC7850126 DOI: 10.1093/ofid/ofaa643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/24/2020] [Indexed: 12/27/2022] Open
Abstract
Background Little is known about the risk of hepatitis C virus (HCV) reinfection among people with HIV (PWH) in the direct-acting antiviral (DAA) era. We evaluate HCV reinfection rates in the DAA era and characterize presustained virologic response (SVR) behavioral risk factors associated with reinfection among PWH at the University of California, San Diego (UCSD). Methods Observational longitudinal cohort of PWH treated with DAAs between 2014 and July 2019 who achieved SVR and had at least 1 subsequent HCV viral load measurement. HCV reinfection was defined as new HCV viremia after SVR. We examined whether screening for sexually transmitted infections (STIs) and substance use during the pre-SVR period could identify patients at greater risk for reinfection using exact Poisson regression to compare reinfection incidence rates between those with and without pre-SVR STIs and positive urine drug screens. Results Eight out of 200 PWH were reinfected with HCV a median ~26 weeks after SVR over 328.1 person-years of follow-up (PYFU), for an incidence rate of 2.44/100 PYFU. The observed HCV reinfection rate was highest among men who have sex with men who inject drugs (MSM IDU; 4.63/100 PFYU) and those aged 30-39 years (6.80/100 PYFU). Having a positive gonorrhea/chlamydia test during the pre-SVR period was a predictor of HCV reinfection. Conclusions The HCV reinfection rate in the DAA era is similar to the rate observed in the interferon era in San Diego in PWH. STI screening during HCV treatment may help determine those at higher risk for HCV reinfection.
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Affiliation(s)
- Lucas A Hill
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, San Diego, California, USA
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, UC San Diego, San Diego, California, USA
| | - Francesca J Torriani
- Division of Infectious Diseases and Global Public Health, Department of Medicine, UC San Diego, San Diego, California, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, UC San Diego, San Diego, California, USA
| | - Huifang Qin
- Department of Medicine, UC San Diego, San Diego, California, USA
| | | | - Edward R Cachay
- Division of Infectious Diseases and Global Public Health, Department of Medicine, UC San Diego, San Diego, California, USA
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19
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Jin F, Dore GJ, Matthews G, Luhmann N, Macdonald V, Bajis S, Baggaley R, Mathers B, Verster A, Grulich AE. Prevalence and incidence of hepatitis C virus infection in men who have sex with men: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 6:39-56. [PMID: 33217341 DOI: 10.1016/s2468-1253(20)30303-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND WHO has set targets for hepatitis C virus (HCV) elimination by 2030. We did a global systematic review of HCV prevalence and incidence in men who have sex with men (MSM) to provide updated estimates that can guide community education and public health policy. METHODS We did a systematic review and meta-analysis of studies published and listed on MEDLINE or Embase between Jan 1, 2000, and Oct 31, 2019, including conference proceedings. Studies were eligible if they reported measures of HCV prevalence or HCV incidence (or both) among MSM. Studies that relied on participants' self-reported HCV status with no laboratory confirmation were excluded. Pooled HCV estimates in MSM were stratified by HIV status and by injecting drug use, then by WHO region and by income level. Random-effects meta-analysis was done to account for between-study heterogeneity and examined using the I2 statistic. Pooled HCV prevalence was also compared with HCV estimates in the general population and presented as prevalence ratios (PRs). In HIV-negative MSM, incidence estimates were stratified by use of HIV pre-exposure prophylaxis (PrEP). The systematic review was registered with PROSPERO, number CRD42020156262. FINDINGS Of 1221 publications identified, 194 were deemed to be eligible and included in the systematic review and meta-analysis. Overall, the pooled HCV prevalence in MSM was 3·4% (95% CI 2·8-4·0; I2=98·0%) and was highest in Africa (5·8%, 2·5-10·4) and South-East Asia (5·0%, 0·0-16·6). Globally, HCV prevalence was 1·5% (1·0-2·1) in HIV-negative MSM and 6·3% (5·3-7·5) in HIV-positive MSM. Compared with the general population, HCV prevalence was slightly higher in HIV-negative MSM (PR 1·58, 95% CI 1·14-2·01) and markedly higher (6·22, 5·14-7·29) in HIV-positive MSM. Pooled HCV prevalence was substantially higher in MSM who had ever injected drugs (30·2%, 22·0-39·0) or currently injected drugs (45·6%, 21·6-70·7) than in those who never injected drugs (2·7%, 2·0-3·6). In HIV-negative MSM, the pooled HCV incidence was 0·12 per 1000 person-years (95% CI 0·00-0·72) in individuals not on PrEP and 14·80 per 1000 person-years (9·65-20·95) in individuals on PrEP. HCV incidence in HIV-positive MSM was 8·46 per 1000 person-years (6·78-10·32). INTERPRETATION HIV-positive MSM are at substantially increased risk of HCV. Overall, HIV-negative MSM had a slightly higher prevalence of HCV than the general population but had a lower prevalence than HIV-positive MSM. High HCV incidence in more recent PrEP studies suggests that as PrEP use increases, greater HCV transmission might occur. HCV burden in MSM varies considerably by region, which is likely to be associated with variation in the prevalence of injecting drug use and HIV. FUNDING World Health Organization.
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Affiliation(s)
- Fengyi Jin
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - Gregory J Dore
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Niklas Luhmann
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Virginia Macdonald
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Sahar Bajis
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Rachel Baggaley
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Bradley Mathers
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Annette Verster
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Andrew E Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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20
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Recently acquired and early chronic hepatitis C in MSM: Recommendations from the European treatment network for HIV, hepatitis and global infectious diseases consensus panel. AIDS 2020; 34:1699-1711. [PMID: 32694411 DOI: 10.1097/qad.0000000000002622] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
: In response to growing evidence of an expanding epidemic of sexually acquired hepatitis C virus (HCV) infection in HIV-positive MSM, the European AIDS Treatment Network (NEAT) acute hepatitis C consensus panel developed their first recommendations for HCV prevention and care during a consensus conference in May 2010 in Paris, France. As then, two major breakthroughs have changed the landscape. First, directly acting antivirals (DAA) with high levels of tolerability and HCV cure rates of over 95% are now widely available and will play a large role in the goal of elimination of HCV by 2030 (WHO sector strategy). Second, landmark studies demonstrated that universal test and treatment (UTT) approach as well as the demonstration that HIV cannot be sexually transmitted from a person living with HIV with an undetectable viraemia [undetectable = untransmittable (U = U) campaign] and HIV preexposure prophylaxis (PrEP) are very effective HIV biomedical prevention strategies for MSM. The scale-up of these interventions has reduced HIV incidence in MSM and also changed patterns of sexual networks and behaviour, which has contributed to increased HCV incidence among HIV-negative MSM who were eligible for or on PrEP. These recent developments, together with new clinical and scientific insights, underscore the importance of updating the statements and recommendations for acute HCV in both HIV-positive and HIV-negative MSM. In June 2019, experts from different disciplines and organizations including community representatives participated at the second acute HCV consensus conference of NEAT Infectious Diseases (ID) in Amsterdam, the Netherlands.
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21
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Prinsenberg T, Zantkuijl P, Zuilhof W, Davidovich U, Schinkel J, Prins M, van der Valk M. Design and Implementation of a Multilevel Intervention to Reduce Hepatitis C Transmission Among Men Who Have Sex With Men in Amsterdam: Co-Creation and Usability Study. JMIR Form Res 2020; 4:e19100. [PMID: 32915157 PMCID: PMC7519430 DOI: 10.2196/19100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 01/05/2023] Open
Abstract
Background In the Netherlands, transmission of hepatitis C virus (HCV) occurs primarily among men who have sex with men (MSM). Early HCV testing of at-risk MSM and immediate initiation of treatment will prevent onward transmission, but this may not be sufficient to eliminate HCV in a population with ongoing risk behaviors. Therefore, targeted socioculturally acceptable preventive measures, including behavioral interventions, are urgently needed. Currently, little contextually appropriate information about HCV or risk reduction interventions is available. Objective The objective of this project was to develop an intervention to reduce HCV transmission among MSM in Amsterdam through a co-creation process, with the input of men from the targeted community directly impacting intervention content, design, and implementation. Methods We developed a multilevel intervention targeting 6 levels: individual, community, professional, context, patient, and network. The intervention was developed in close cooperation between health professionals, gay community members, commercial stakeholders, and stakeholders from within the gay community. The co-creation process had 4 phases: a needs assessment, stakeholder engagement, co-creation, and implementation. The co-creation phase continued until consensus was reached between the researchers and community members on the intervention content and design. The final intervention, NoMoreC, was completed within 2 years, and implementation started in February 2018. Results NoMoreC includes web-based and face-to-face components as well as an anonymous HCV testing service. The NoMoreC website provides information about hepatitis C, HCV transmission routes, risk reduction strategies, testing and treatment options, and partner notification. The face-to-face component comprises a risk reduction toolbox, training for health professionals, and providing tailored advice to sex on premises venues. NoMoreC is promoted by an active voluntary campaign team. Conclusions Involving the community and stakeholders in the creation of NoMoreC has been the main strength of this project. It has resulted in an intervention with various components that resonates with the gay community at risk of HCV infection. The uptake and acceptability of the described intervention will be evaluated in the future. The description of the co-creation process and implementation of the project may serve as a rich and useful source for others who want to develop culturally and context appropriate HCV interventions.
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Affiliation(s)
- Tamara Prinsenberg
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, Amsterdam, Netherlands.,Department of Infectious Diseases, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Infection & Immunity Institute, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Udi Davidovich
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, Amsterdam, Netherlands.,Department of Social Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Janke Schinkel
- Amsterdam Infection & Immunity Institute, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands.,Department of Medical Microbiology, Section of Clinical Virology, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands
| | - Maria Prins
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, Amsterdam, Netherlands.,Department of Infectious Diseases, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Infection & Immunity Institute, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands
| | - Marc van der Valk
- Department of Infectious Diseases, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Infection & Immunity Institute, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam, Netherlands
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22
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Ho SY, Su LH, Sun HY, Huang YS, Chuang YC, Huang MH, Liu WC, Su YC, Lin PH, Chang SY, Hung CC. Trends of recent hepatitis C virus infection among HIV-positive men who have sex with men in Taiwan, 2011-2018. EClinicalMedicine 2020; 24:100441. [PMID: 32637905 PMCID: PMC7327892 DOI: 10.1016/j.eclinm.2020.100441] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Increasing trends of HCV infection have been reported among HIV-positive men who have sex with men (MSM) in Europe, Australia and North America. The trends of recently acquired HCV infection among HIV-positive MSM are less clear in Asia-pacific region. METHODS All HIV-positive patients seeking care at a university hospital in Taiwan tested for anti-HCV IgG at least once annually to estimate the incidence of HCV seroconversion during 2011-2018. HCV genotyping and sequencing were performed and multivariate logistic regression analysis was conducted to identify the factors associated with HCV seroconversion among MSM. FINDINGS During the study period, 3495 HCV-seronegative patients (86·4% MSM) were included and 294 (8·4%) with recent HCV infection were identified, in whom 281 (95·6%) were MSM, during a total of 16,361·86 person-years of follow-up (PYFU), giving an overall incidence rate of 17·97 per 1000 PYFU, which increased from 14·28 per 1000 PYFU in 2011 to 25·38 per 1000 PYFU in 2018 (p<0·001). HCV seroconversion among MSM was associated with aspartate aminotransferase ≥37 U/L (adjusted odds ratio [AOR] 7·50, 95% CI 4·17-13·50), alanine aminotransferase ≥41 U/L (AOR 7·47, 95% CI 4·11-13·58), and syphilis acquisition (AOR 2·88, 95% CI 1·67-4·97). Among the 277 (94·2%) with HCV viremia, genotype 2a (n = 116) was the leading genotype, followed by 1b (n = 85), 6a (n = 34), and 1a (n = 21). Genotypes 3a and 6a increased from 0% and 5·2%, respectively, in 2011-2014 to 4·1% and 17·1% in 2015-2018. Phylogenetic analysis revealed increased clusters in genotypes 2a, 3a and 6a from 2011-2014 to 2015-2018. INTERPRETATION An expanding HCV epidemic among HIV-positive MSM is occurring in Taiwan. Improving access to HCV testing and early linkage to treatment are needed to curb the expanding HCV epidemic. FUNDING This research was supported by a grant from National Taiwan University Hospital, Taipei, Taiwan (NTUH.106-003347 to Hsin-Yun Sun).
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Affiliation(s)
- Shu-Yuan Ho
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Hsin Su
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Shan Huang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Chung Chuang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Miao-Hui Huang
- Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
| | - Wen-Chun Liu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Ching Su
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pi-Han Lin
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sui-Yuan Chang
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
- Corresponding author at: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan.
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- China Medical University, Taichung, Taiwan
- Corresponding author at: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan.
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23
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Grov C, Westmoreland DA, Carrico AW, Nash D. Are we on the precipice of a new epidemic? Risk for hepatitis C among HIV-negative men-, trans women-, and trans men- who have sex with men in the United States. AIDS Care 2020; 32:74-82. [PMID: 32172589 PMCID: PMC7312766 DOI: 10.1080/09540121.2020.1739204] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/25/2020] [Indexed: 01/18/2023]
Abstract
Emerging data from Europe have documented increases in diagnoses of acute hepatitis C virus (HCV) infection among HIV-negative men who have sex with men. We investigated risk factors for HCV and their correlates in the Together 5000 study, a U.S. national cohort study of HIV-negative men (n = 6089), transgender women (n = 40), and transgender men (n = 42) who have sex with men. We used bivariate and multivariable analyses to determine demographic and behavioral factors associated with high risk for acute HCV infection (using the HCV-MOSAIC risk indicator with a score ≥ 2.0). Mean HCV risk score was 1.38 (SD = 1.09) and 27.3% of participants had HCV risk scores ≥ 2.0. In multivariable modeling, being cisgender male (vs. not) was associated with having a lower HCV-MOSAIC risk score. Meanwhile, being white, having been incarcerated, prior use of HIV pre- or post-exposure prophylaxis, having ever been tested for HIV, and recent methamphetamine use were associated with high risk for HCV. More than one-in-four participants exceeded the threshold score for HCV risk. Those with high HCV-MOSAIC risk scores were more likely to have been in settings where they could be tested for acute HCV (i.e., HIV testing, PrEP care, PEP care, incarceration), suggesting opportunities to engage them in HCV screening, prevention, and treatment.
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Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | | | - Adam W. Carrico
- Departments of Public Health Sciences and Psychology, University of Miami, Coral Gables, Florida, USA
| | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
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24
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Clement ME, Collins LF, Wilder JM, Mugavero M, Barker T, Naggie S. Hepatitis C Virus Elimination in the Human Immunodeficiency Virus-Coinfected Population: Leveraging the Existing Human Immunodeficiency Virus Infrastructure. Infect Dis Clin North Am 2018; 32:407-423. [PMID: 29778263 PMCID: PMC6592269 DOI: 10.1016/j.idc.2018.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The objective of this review is to consider how existing human immunodeficiency virus (HIV) infrastructure may be leveraged to inform and improve hepatitis C virus (HCV) treatment efforts in the HIV-HCV coinfected population. Current gaps in HCV care relevant to the care continuum are reviewed. Successes in HIV treatment are then applied to the HCV treatment model for coinfected patients. Finally, the authors give examples of HCV treatment strategies for coinfected patients in both domestic and international settings.
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Affiliation(s)
- Meredith E Clement
- Division of Infectious Diseases, Duke University Medical Center, 315 Trent Drive, Hanes House, Room 181, DUMC Box 102359, Durham, NC 27710, USA
| | - Lauren F Collins
- Department of Medicine, Emory School of Medicine, 49 Jesse Hill Drive Southeast, Atlanta, GA 30303, USA
| | - Julius M Wilder
- Duke Division of Gastroenterology, Box 90120, Durham, NC 27708-0120, USA; Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA
| | - Michael Mugavero
- Division of Infectious Diseases, University of Alabama Birmingham, Community Care Building, 908 20th Street South, Birmingham, AL 35294, USA
| | - Taryn Barker
- Clinton Health Access Initiative, 383 Dorchester Avenue, Boston, MA 02127, USA
| | - Susanna Naggie
- Division of Infectious Diseases, Duke University Medical Center, 315 Trent Drive, Hanes House, Room 181, DUMC Box 102359, Durham, NC 27710, USA; Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA.
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