Impact of test-and-treat and risk reduction strategies on HCV transmission among MSM living with HIV in France: a modelling approach.
HCV
HIV/AIDS
antiviral therapy
chronic hepatitis
decision analysis
Journal
Gut
ISSN: 1468-3288
Titre abrégé: Gut
Pays: England
ID NLM: 2985108R
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
07
05
2020
revised:
24
09
2020
accepted:
02
10
2020
pubmed:
29
10
2020
medline:
26
10
2022
entrez:
28
10
2020
Statut:
ppublish
Résumé
Since the early 2000s, there has been an epidemic of HCV occurring among men who have sex with men (MSM) living with HIV, mainly associated with high-risk sexual and drug-related behaviours. Early HCV diagnosis and treatment, and behavioural risk-reduction, may be effective to eliminate HCV among MSM living with HIV. We developed a deterministic dynamic compartmental model to simulate the impact of test-and-treat and risk-reduction strategies on HCV epidemic (particularly on incidence and prevalence) among MSM living with HIV in France. We accounted for HIV and HCV cascades of care, HCV natural history and heterogeneity in HCV risk behaviours. The model was calibrated to primary HCV incidence observed between 2014 and 2017 among MSM living with HIV in care (ANRS CO4-French hospital database on HIV (FHDH)). With current French practices (annual HCV screening and immediate treatment), total HCV incidence would fall by 70%, from 0.82/100 person-years in 2015 to 0.24/100 person-years in 2030. It would decrease to 0.19/100 person-years in 2030 with more frequent screening and to 0.19 (0.12)/100 person-years in 2030 with a 20% (50%) risk-reduction. When combining screening every 3 months with a 50% risk-reduction, HCV incidence would be 0.11/100 person-years in 2030, allowing to get close to the WHO target (90% reduction from 2015 to 2030). Similarly, HCV prevalence would decrease from 2.79% in 2015 to 0.48% in 2030 (vs 0.71% with current practices). Combining test-and-treat and risk-reduction strategies could have a marked impact on the HCV epidemic, paving the way to HCV elimination among MSM living with HIV.
Identifiants
pubmed: 33109688
pii: gutjnl-2020-321744
doi: 10.1136/gutjnl-2020-321744
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1561-1569Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: VS has served on advisory boards for ViiV Healthcare (2016) and Gilead (2018) and reports lecture fees from Gilead (2017, 2019 and 2020), Janssen (2018 and 2020) and ViiV (2019), AbbVie (2018), outside the submitted work. SD-B has received consultancy honoraria from Intercept.