A Treatment-as-Prevention Trial to Eliminate Hepatitis C Among Men Who Have Sex With Men Living With Human Immunodeficiency Virus (HIV) in the Swiss HIV Cohort Study

被引：43

作者：

Braun, Dominique L. ^{[1
,2
,3
]}

Hampel, Benjamin ^{[1
,2
,3
]}

Ledergerber, Bruno ^{[1
,2
]}

Grube, Christina ^{[1
,2
]}

Nguyen, Huyen ^{[1
,2
]}

Kunzler-Heule, Patrizia ^{[4
]}

Shah, Cyril ^{[3
]}

Salazar-Vizcaya, Luisa ^{[5
]}

Conen, Anna ^{[6
]}

Flepp, Markus ^{[7
]}

Stockle, Marcel ^{[8
]}

Beguelin, Charles ^{[5
]}

Schmid, Patrick ^{[9
]}

Rougemont, Mathieu ^{[10
]}

Delaloye, Julie ^{[11
,12
]}

Bernasconi, Enos ^{[13
]}

Nicca, Dunja ^{[4
,14
]}

Boni, Jurg ^{[3
]}

Rauch, Andri ^{[5
]}

Kouyos, Roger D. ^{[1
,2
,3
]}

Gunthard, Huldrych F. ^{[1
,2
,3
]}

Fehr, Jan S. ^{[1
,2
,14
]}

机构：

[1] Univ Zurich, Univ Hosp Zurich, Div Infect Dis, Raemistr 100, CH-8091 Zurich, Switzerland

[2] Univ Zurich, Hosp Epidemiol, Univ Hosp Zurich, Raemistr 100, CH-8091 Zurich, Switzerland

[3] Univ Zurich, Inst Med Virol, Zurich, Switzerland

[4] Univ Basel, Inst Nursing Sci, Basel, Switzerland

[5] Univ Bern, Bern Univ Hosp, Dept Infect Dis, Bern, Switzerland

[6] Cantonal Hosp Aarau, Dept Infect Dis & Hosp Hyg, Aarau, Switzerland

[7] Ctr Infect Dis Zurich, Zurich, Switzerland

[8] Univ Basel, Univ Hosp Basel, Div Infect Dis & Hosp Epidemiol, Basel, Switzerland

[9] Cantonal Hosp St Gallen, Div Infect Dis, St Gallen, Switzerland

[10] Univ Hosp Geneva, Primary Care Med Div, Geneva, Switzerland

[11] Univ Lausanne, Dept Intens Care Med, Intens Care Unit, Lausanne, Switzerland

[12] Univ Hosp Ctr Lausanne, Lausanne, Switzerland

[13] Reg Hosp Lugano, Div Infect Dis, Lugano, Switzerland

[14] Univ Zurich, Epidemiol Biostat & Prevent Inst, Dept Publ & Global Hlth, Zurich, Switzerland

来源：

CLINICAL INFECTIOUS DISEASES | 2021年 / 73卷 / 07期

基金：

瑞士国家科学基金会;

关键词：

HIV; hepatitis C virus; men who have sex with men; micro-elimination; treatment as prevention; VIRAL-HEPATITIS; INFECTIONS;

D O I：

10.1093/cid/ciaa1124

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. In 2016, the World Health Organization (WHO) introduced global targets for the elimination of hepatitis C virus (HCV) by 2030. We conducted a nationwide HCV micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) from the Swiss HIV Cohort Study (SHCS) to test whether the WHO goals are achievable in this population. Methods. During phase A (10/2015-06/2016), we performed a population-based and systematic screening for HCV-RNA among MSM from the SHCS. During phase B (06/2016-02/2017) we offered treatment with HCV direct-acting antiviral (DAA) agents to MSM identified with a replicating HCV infection. During phase C (03/2017-11/2017), we offered rescreening to all MSM for HCV-RNA and initiated DAA treatment in MSM with replicating infections. Results. We screened 3715/4640 (80%) MSM and identified 177 with replicating HCV infections (4.8%); 150 (85%) of whom started DAA treatment and 149 (99.3%) were cured. We rescreened 2930/3538 (83%) MSM with a prior negative HCV-RNA and identified 13 (0.4%) with a new HCV infection. At the end of the micro-elimination program, 176/190 MSM (93%) were cured, and the HCV incidence rate declined from .53 per 100 patient-years (95% CI, .35-.83) prior to the intervention to .12 (95% CI, .03-.49) by the end of 2019. Conclusions. A systematic, population-based HCV micro-elimination program among MSM living with HIV was feasible and resulted in a strong decline in HCV incidence and prevalence. Our study can serve as a model for other countries aiming to achieve the WHO HCV elimination targets.

引用

页码：E2194 / E2202

页数：9