Establishing a framework towards monitoring HCV microelimination among men who have sex with men living with HIV in Germany: A modeling analysis.

Abstract

BACKGROUND:

Prior to direct-acting antivirals (DAAs), HCV incidence rose among men who have sex with men (MSM) living with HIV infection in Germany despite high hepatitis C virus (HCV) treatment rates. We establish a HCV elimination modeling framework to evaluate whether existing treatment rates can achieve the World Health Organization (WHO) incidence target among MSM living with HIV in Germany.

METHODS:

To evaluate progress towards HCV elimination in Germany, we adapted a previously published HCV transmission model among MSM living with diagnosed HIV. We modelled HCV incidence and prevalence until 2030 (relative to 2015) under existing treatment and DAA scale-up and explored potential impacts of disruptions in treatment and behavioral risk reduction due to the COVID-19 pandemic.

RESULTS:

Continuing current treatment rates will result in stable HCV incidence among MSM living with HIV in Germany between 2015-2030. The WHO HCV incidence target is achievable under DAA scale-up to 100% treatment combined with treatment of those previously diagnosed and untreated (at a rate of 15%/year) and would result in greater reductions with early treatment (3 vs 6 months) reducing incidence from 4.0/100person-years to 0.8/100person-years by 2030. A 12-month disruption to HCV treatment (20% reduction) and risk behaviors (25%,50%,75% reduction) during the COVID-19 pandemic would result in a 15% relative increase in total HCV incidence in 2030 compared to that expected under the status quo.

CONCLUSIONS:

HCV elimination among MSM living with HIV in Germany requires further DAA scale-up among those newly diagnosed combined with efforts to treat those previously diagnosed but untreated. Prospective monitoring will establish whether Germany is on track for HCV microelimination.

• Authors: Lara K Marquez, Patrick Ingiliz, Christoph Boesecke, Ivanka Krznaric, Knud Schewe, Thomas Lutz, Stefan Mauss, Stefan Christensen, Jürgen K Rockstroh, Sonia Jain, Feng He, Joel O Wertheim, Natasha K Martin
• Journal: PloS one (PLoS One) Vol. 17 Issue 5 Pg. e0267853 ( 2022) ISSN: 1932-6203 [Electronic] United States
• PMID: 35551326 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents

Topics

• Antiviral Agents (therapeutic use)
• COVID-19 (epidemiology)
• Germany (epidemiology)
• HIV Infections (drug therapy, epidemiology)
• Hepacivirus
• Hepatitis C (drug therapy, epidemiology)
• Hepatitis C, Chronic (drug therapy)
• Homosexuality, Male
• Humans
• Incidence
• Male
• Pandemics
• Prospective Studies
• Sexual and Gender Minorities