Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions

Autor: Salazar-Vizcaya, Luisa, Kouyos, Roger D, Zahnd, Cindy, Wandeler, Gilles, Battegay, Manuel, Darling, Katharine Elizabeth Anna, Bernasconi, Enos, Calmy, Alexandra, Vernazza, Pietro, Furrer, Hansjakob, Egger, Matthias, Keiser, Olivia, Rauch, Andri, Swiss HIV Cohort Study
Přispěvatelé: University of Zurich, Keiser, Olivia, Swiss HIV Cohort Study
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Epidemiology
Viral Hepatitis
HIV Infections
Hepacivirus
medicine.disease_cause
Men who have sex with men
Cohort Studies
10234 Clinic for Infectious Diseases
Sexual and Gender Minorities
0302 clinical medicine
Theoretical
Models
Behavior Therapy
Prevalence
Medicine
030212 general & internal medicine
ddc:616
Antiviral Agents/therapeutic use
education.field_of_study
Transmission (medicine)
Incidence (epidemiology)
Incidence
virus diseases
Homosexuality
Hepatitis C
3. Good health
030211 gastroenterology & hepatology
HIV Infections/complications/drug therapy
Cohort study
Adult
medicine.medical_specialty
Hepatitis C virus
Population
610 Medicine & health
Antiviral Agents
03 medical and health sciences
Internal medicine
Humans
Homosexuality
Male
education
ddc:613
Hepatology
business.industry
HIV Infections/complications
HIV Infections/drug therapy
Hepatitis C/epidemiology
Hepatitis C/prevention & control
Hepatitis C/transmission
Models
Theoretical
Treatment
Institutional repository
Immunology
2721 Hepatology
Hepatitis C/epidemiology/prevention & control/transmission
business
Zdroj: Hepatology (Baltimore Md.)
Hepatology, Vol. 64, No 6 (2016) pp. 1856-1869
Hepatology, vol. 64, no. 6, pp. 1856-1869
Hepatology (Baltimore, Md.)
ISSN: 0270-9139
Popis: The incidence of hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)‐infected men who have sex with men has increased in recent years and is associated with high‐risk sexual behavior. Behavioral interventions that target high‐risk behavior associated with HCV transmission and treatment with direct‐acting antivirals may prevent further HCV infections. We predicted the effect of behavioral and treatment interventions on HCV incidence and prevalence among HIV‐infected men who have sex with men up to 2030 using a HCV transmission model parameterized with data from the Swiss HIV Cohort Study. We assessed behavioral interventions associated with further increase, stabilization, and decrease in the size of the population with high‐risk behavior. Treatment interventions included increase in treatment uptake and use of direct‐acting antivirals. If we assumed that without behavioral interventions high‐risk behavior spread further according to the trends observed over the last decade and that the treatment practice did not change, HCV incidence converged to 10.7/100 person‐years. All assessed behavioral interventions alone resulted in reduced HCV transmissions. Stabilization of high‐risk behavior combined with increased treatment uptake and the use of direct‐acting antivirals reduced incidence by 77% (from 2.2 in 2015 to 0.5/100 person‐years) and prevalence by 81% (from 4.8% in 2015 to 0.9%) over the next 15 years. Increasing treatment uptake was more effective than increasing treatment efficacy to reduce HCV incidence and prevalence. A decrease in high‐risk behavior led to a rapid decline in HCV incidence, independent of treatment interventions. Conclusion: Treatment interventions to curb the HCV epidemic among HIV‐infected men who have sex with men are effective if high‐risk behavior does not increase as it has during the last decade; reducing high‐risk behavior associated with HCV transmission would be the most effective intervention for controlling the HCV epidemic, even if this was not accompanied by an increase in treatment uptake or efficacy. (Hepatology 2016;64:1856‐1869).
Databáze: OpenAIRE
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