Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions.

Details

Ressource 1Download: 27531615_BIB_87C4AA768159.pdf (704.67 [Ko])
State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_87C4AA768159
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions.
Journal
Hepatology
Author(s)
Salazar-Vizcaya L., Kouyos R.D., Zahnd C., Wandeler G., Battegay M., Darling K.E., Bernasconi E., Calmy A., Vernazza P., Furrer H., Egger M., Keiser O., Rauch A.
Working group(s)
Swiss HIV Cohort Study
ISSN
1527-3350 (Electronic)
ISSN-L
0270-9139
Publication state
Published
Issued date
12/2016
Peer-reviewed
Oui
Volume
64
Number
6
Pages
1856-1869
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The incidence of hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)-infected men who have sex with men has increased in recent years and is associated with high-risk sexual behavior. Behavioral interventions that target high-risk behavior associated with HCV transmission and treatment with direct-acting antivirals may prevent further HCV infections. We predicted the effect of behavioral and treatment interventions on HCV incidence and prevalence among HIV-infected men who have sex with men up to 2030 using a HCV transmission model parameterized with data from the Swiss HIV Cohort Study. We assessed behavioral interventions associated with further increase, stabilization, and decrease in the size of the population with high-risk behavior. Treatment interventions included increase in treatment uptake and use of direct-acting antivirals. If we assumed that without behavioral interventions high-risk behavior spread further according to the trends observed over the last decade and that the treatment practice did not change, HCV incidence converged to 10.7/100 person-years. All assessed behavioral interventions alone resulted in reduced HCV transmissions. Stabilization of high-risk behavior combined with increased treatment uptake and the use of direct-acting antivirals reduced incidence by 77% (from 2.2 in 2015 to 0.5/100 person-years) and prevalence by 81% (from 4.8% in 2015 to 0.9%) over the next 15 years. Increasing treatment uptake was more effective than increasing treatment efficacy to reduce HCV incidence and prevalence. A decrease in high-risk behavior led to a rapid decline in HCV incidence, independent of treatment interventions.
Treatment interventions to curb the HCV epidemic among HIV-infected men who have sex with men are effective if high-risk behavior does not increase as it has during the last decade; reducing high-risk behavior associated with HCV transmission would be the most effective intervention for controlling the HCV epidemic, even if this was not accompanied by an increase in treatment uptake or efficacy. (Hepatology 2016;64:1856-1869).
Keywords
Adult, Antiviral Agents/therapeutic use, Behavior Therapy, Cohort Studies, HIV Infections/complications, HIV Infections/drug therapy, Hepatitis C/epidemiology, Hepatitis C/prevention & control, Hepatitis C/transmission, Homosexuality, Male, Humans, Incidence, Male, Models, Theoretical, Prevalence
Pubmed
Web of science
Open Access
Yes
Create date
15/09/2016 19:26
Last modification date
09/04/2020 5:26
Usage data