The widespread use of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) in London has coincided with a swift and dramatic decline in the rate of new HCV infections among HIV-positive men who have sex with men (MSM) attending sexual health clinics in the English capital, aidsmap reports.
HIV-positive MSM have historically been at significant risk of contracting HCV through sex in various Western nations, including England and the United States.
Presenting their findings at the 2019 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, researchers analyzed data on new diagnoses of HCV as well as reinfections following clearance of the virus among about 6,000 MSM living with HIV who attended one of three London sexual health clinics.
In 2016, the British National Health Service started offering coverage of DAA treatment for HCV regardless of liver-disease severity. However, the NHS does not cover hep C treatment during the first six months of infection, during which there is a moderate chance the body may clear the virus on its own. Nor does the NHS cover DAA treatment for reinfections. However, the three clinics included in the study were involved in clinical trials of DAAs that provided less restricted access to hep C treatment.
Between July 2013 and June 2018, there were 256 diagnoses of acute, or very recent, hep C infection among the HIV-positive MSM. Of those infections, 111 were an individual’s first infection and 45 were reinfections. The men had a median age of 43 upon diagnosis.
During the study period, the rate of HCV diagnoses peaked in 2015, at 17 cases per 1,000 cumulative years of follow-up. That year also saw the peak of first HCV infections, at 15 cases per 1,000 cumulative years of follow-up. These rates then declined rapidly and steadily, hitting six overall HCV diagnoses and three new hep C diagnoses per cumulative 1,000 years of follow-up in 2018. This meant that the rate of HCV diagnoses declined by 68 percent and the rate of first diagnoses declined by 79 percent in just three years.
To read the aidsmap article, click here.
To read the conference abstract, click here.
To view a webcast of the conference presentation, click here.