Hepatitis C virus (HCV) incidence among men who have sex with men (MSM) living with HIV: results from the French Hospital Database on HIV (ANRS CO4-FHDH) cohort study, 2014 to 2017

Abstract

Background Despite the availability of highly effective direct-acting antivirals (DAAs) and the expected treatment as prevention (TasP) effect, transmission of hepatitis C virus (HCV) persists in men who have sex with men (MSM) who engage in high-risk sexual behaviours. Aim We aimed to estimate the incidence of primary HCV infection among MSM living with HIV in France when DAA was readily available. Methods We used data from a large French hospital cohort of persons living with HIV (ANRS CO4-FHDH) prospectively collected between 2014 and 2017. HCV incidence rates were calculated using person-time methods for HCV-negative MSM at inclusion who had serological follow-up from 1 January 2014 to 31 December 2017. Sensitivity analyses were performed by varying the main assumptions to assess their impact on the results. Results Of 14,273 MSM living with HIV who were initially HCV-seronegative, 330 acquired HCV during follow-up over 45,866 person-years (py), resulting in an overall estimated incidence rate of 0.72/100 py (95% CI: 0.65–0.80). HCV incidence significantly decreased from 0.98/100 py (95% CI: 0.81–1.19) in 2014 to 0.45/100 py (95% CI: 0.35–0.59) in 2017 (54% decrease; 95% CI: 36–67). This trend was confirmed by most of the sensitivity analyses. Conclusion The primary incidence of HCV was halved for MSM living with HIV between 2014 and 2017. This decrease may be related to unrestricted DAA availability in France for individuals living with HIV. Further interventions, including risk reduction, are needed to reach HCV micro-elimination in MSM living with HIV.

Incidence of hepatitis C virus infection among people living with HIV: An Egyptian cohort study

“…The incidence rates of HIV/HCV co-infection in some Asian and European countries were lower than that reported in this study with a rate of 0.88 per 100 person-years in Singapore, 19 and 0.72 and 0.44 per 100 person-years among MSM in France 20 and Italy 21 . A systematic review conducted between 2000 and 2016 reported an incidence rate of 0.78 per 100 person-years among MSM.…”

Treatment as prevention effect of direct-acting antivirals on primary hepatitis C virus incidence: findings from a multinational cohort between 2010 and 2019

“…Evidence from cohorts of PLHIV in high-income countries have shown decreases in primary HCV incidence in recent years, particularly after DAA introduction. [14][15][16][17][18][19][20] However, in some countries, primary incidence was declining before DAA introduction, or trends in incidence have only been analysed during the DAA era. Therefore, it is unclear whether observed incidence reductions would have occurred even without DAAs.…”

Hepatitis C virus reinfection incidence among gay and bisexual men with HIV in Australia from 2016 to 2020

“…We limited the observation period to the end of 2020 to limit uncertainly in estimates in the final year of data availability as people were censored at their last HCV RNA test with no extra time added and this may result in artificially inflated incidence rates. 16 Testing history prior to the reinfection observation period was included for two reasons. Firstly, some GBM may have been known to have established chronic HCV, and as such may not have had additional HCV RNA testing in close proximity prior to commencing DAA treatment (Figure S1).…”