On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: A mathematical modelling study.

Details

Serval ID
serval:BIB_5C9D53A95FAF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: A mathematical modelling study.
Journal
Journal of viral hepatitis
Author(s)
Salazar-Vizcaya L., Kouyos R.D., Fehr J., Braun D., Estill J., Bernasconi E., Delaloye J., Stöckle M., Schmid P., Rougemont M., Wandeler G., Günthard H.F., Keiser O., Rauch A.
Working group(s)
Swiss HIV Cohort Study
ISSN
1365-2893 (Electronic)
ISSN-L
1352-0504
Publication state
Published
Issued date
01/2018
Peer-reviewed
Oui
Volume
25
Number
1
Pages
10-18
Language
english
Notes
Publication types: Clinical Trial, Phase III ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Increasing access to direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection and decelerating the rise in high-risk behaviour over the next decade could curb the HCV epidemic among HIV-positive men who have sex with men (MSM). We investigated if similar outcomes would be achieved by short-term intensive interventions like the Swiss-HCVree-trial. We used a HCV transmission model emulating two 12-months intensive interventions combining risk counselling with (i) universal DAA treatment (pangenotypic intervention) and (ii) DAA treatment for HCV genotypes 1 and 4 (replicating the Swiss-HCVree-trial). To capture potential changes outside intensive interventions, we varied time from HCV infection to treatment in clinical routine and overall high-risk behaviour among HIV-positive MSM. Simulated prevalence dropped from 5.5% in 2016 to ≤2.0% over the intervention period (June/2016-May/2017) with the pangenotypic intervention, and to ≤3.6% with the Swiss-HCVree-trial. Assuming time to treatment in clinical routine reflected reimbursement restrictions (METAVIR ≥F2, 16.9 years) and stable high-risk behaviour in the overall MSM population, prevalence in 2025 reached 13.1% without intensive intervention, 11.1% with the pangenotypic intervention and 11.8% with the Swiss-HCVree-trial. If time to treatment in clinical routine was 2 years, prevalence in 2025 declined to 4.8% without intensive intervention, to 2.8% with the pangenotypic intervention, and to 3.5% with the Swiss-HCVree-trial. In this scenario, the pangenotypic intervention and the Swiss-HCVree-trial reduced cumulative (2016-2025) treatment episodes by 36% and 24%, respectively. Therefore, intensive interventions could reduce future HCV treatment costs and boost the benefits of long-term efforts to prevent high-risk behaviour and to reduce treatment delay. But if after intensive interventions treatment is deferred until F2, short-term benefits of intensive interventions would dissipate in the long term.
Keywords
Antiviral Agents/therapeutic use, Communicable Disease Control/methods, Counseling/utilization, Disease Transmission, Infectious/prevention & control, HIV Infections/complications, Hepatitis C/epidemiology, Hepatitis C/prevention & control, Hepatitis C/transmission, Homosexuality, Male, Humans, Male, Models, Theoretical, Prevalence, Risk-Taking, HIV, direct-acting antivirals, hepatitis C virus, men who have sex with men, treatment as prevention
Pubmed
Web of science
Create date
04/08/2017 14:13
Last modification date
20/08/2019 14:15
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