Journal Article

Eliminating Hepatitis C Virus Among Human Immunodeficiency Virus–Infected Men Who Have Sex With Men in Berlin

Lutz, Thomas, Christensen, Stefan, Boesecke, Christoph, Ingiliz, Patrick, Mauss, Stefan, Skaathun, Britt, Boyd, Anders, Rockstroh, Jürgen K., Thielen, Alexander, Jansen, Klaus, Baumgarten, Axel, an der Heiden, Matthias, Schewe, Knud, Martin, Natasha K.

2019

Overview

Abstract Background Despite high hepatitis C virus (HCV) treatment rates, HCV incidence among human immunodeficiency virus (HIV)–infected men who have sex with men (HIV-infected MSM) in Germany rose before HCV direct-acting antivirals (DAAs). We model what intervention can achieve the World Health Organization (WHO) elimination target of an 80% reduction in HCV incidence by 2030 among HIV-infected MSM in Berlin. Methods An HCV transmission model among HIV-diagnosed MSM was calibrated to Berlin (rising HCV incidence and high rates of HCV testing and treatment). We modeled the HCV incidence among HIV-diagnosed MSM in Berlin until 2030 (relative to 2015 WHO baseline) under scenarios of DAA scale-up with or without behavior change (among HIV-diagnosed MSM and/or all MSM). Results Continuing current treatment rates will marginally reduce the HCV incidence among HIV-diagnosed MSM in Berlin by 2030. Scaling up DAA treatment rates, beginning in 2018, to 100% of newly diagnosed HCV infections within 3 months of diagnosis and 25% each year of previously diagnosed and untreated HCV infections could reduce the HCV incidence by 61% (95% confidence interval, 55.4%–66.7%) by 2030. The WHO target would likely be achieved by combining DAA scale-up with a 40% reduction in HCV transmission among HIV-diagnosed MSM and a 20% reduction among HIV-undiagnosed or HIV-uninfected MSM. Discussion HCV elimination among HIV-infected MSM in Berlin likely requires combining DAA scale-up with moderately effective behavioral interventions to reduce risk among all MSM. Dynamic modeling indicates that hepatitis C virus elimination among human immunodeficiency virus–infected men who have sex with men (MSM) in Berlin likely requires combining direct-acting antiviral scale-up with moderately effective behavioral interventions to reduce risk among all MSM.

• Publisher: Oxford University Press
• Subject: Adult / Antiviral agents / Antiviral Agents - therapeutic use / Antiviral drugs / Behavior Therapy - methods / Berlin - epidemiology / Disease prevention / Disease transmission / Disease Transmission, Infectious - prevention & control / Gays & lesbians / Hepatitis / Hepatitis C / Hepatitis C, Chronic - drug therapy / Hepatitis C, Chronic - epidemiology / Hepatitis C, Chronic - transmission / HIV / HIV Infections - complications / HIV/AIDS / Homosexuality, Male / Human immunodeficiency virus / Humans / Incidence / Major and Brief Reports / Male / Mens health / Models, Statistical / Treatment Outcome / Young Adult