On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: a mathematical modelling study.

Salazar-Vizcaya, Luisa; Kouyos, Roger D; Fehr, Jan; Braun, Dominique; Estill, Janne Anton Markus; Bernasconi, Enos; Delaloye, Julie; Stöckle, Marcel; Schmid, Patrick; Rougemont, Mathieu; Wandeler, Gilles; Günthard, Huldrych F; Keiser, Olivia; Rauch, Andri (2018). On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: a mathematical modelling study. Journal of viral hepatitis, 25(1), pp. 10-18. Blackwell Science 10.1111/jvh.12752

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This is the peer reviewed version of the following article: Salazar-Vizcaya, Luisa; Kouyos, Roger D; Fehr, Jan; Braun, Dominique; Estill, Janne; Bernasconi, Enos; Delaloye, Julie; Stöckle, Marcel; Schmid, Patrick; Rougemont, Mathieu; Wandeler, Gilles; Günthard, Huldrych F; Keiser, Olivia; Rauch, Andri (2017). On the potential of a short-term intensive intervention to interrupt HCV transmission in HIV-positive men who have sex with men: a mathematical modelling study. Journal of viral hepatitis, which has been published in final form at 10.1111/jvh.12752. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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Increasing access to direct-acting antiviral (DAA)-treatment for hepatitis C virus (HCV) infection and decelerating the rise in high-risk behaviour over the next decade, could curb the HCV epidemic among HIV-positive men-who-have-sex-with-men (MSM). We investigated if similar outcomes would be achieved by short-term intensive interventions like the Swiss-HCVree-trial. We used a HCV-transmission model emulating two 12-months intensive-interventions combining risk-counselling with 1) universal DAA-treatment (pangenotypic intervention) and 2) DAA-treatment for HCV-genotypes 1 and 4 (replicating the Swiss-HCVree-trial). To capture potential changes outside intensive-interventions, we varied time from HCV-infection to treatment in clinical-routine and overall high-risk behaviour among HIV-positive MSM. Simulated prevalence dropped from 5.5% in 2016 to ≤2.0% over the intervention period (June/2016-May/2017) with the pangenotypic-intervention, and to ≤3.6% with the Swiss-HCVree-trial. Assuming time to treatment in clinical-routine reflected reimbursement restrictions (METAVIR ≥F2, 16.9 years) and stable high-risk behaviour in the overall MSM population, prevalence in 2025 reached 13.1% without intensive intervention, 11.1% with the pangenotypic intervention and 11.8% with the Swiss-HCVree-trial. If time to treatment in clinical-routine was 2 years, prevalence in 2025 declined to 4.8% without intensive-intervention, to 2.8% with the pangenotypic intervention, and to 3.5% with the Swiss-HCVree-trial. In this scenario, the pangenotypic intervention and the Swiss-HCVree-trial reduced cumulative (2016-2025) treatment episodes by 36% and 24% respectively. Therefore, intensive interventions could reduce future HCV-treatment costs and boost the benefits of long-term efforts to prevent high-risk behaviour and to reduce treatment delay. But if after intensive interventions treatment is deferred until F2, short-term benefits of intensive interventions would dissipate in the long-term. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

08 Faculty of Science > Department of Mathematics and Statistics > Institute of Mathematical Statistics and Actuarial Science
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Salazar Vizcaya, Luisa Paola; Estill, Janne Anton Markus; Wandeler, Gilles; Keiser, Olivia and Rauch, Andri

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 510 Mathematics

ISSN:

1352-0504

Publisher:

Blackwell Science

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

10 Aug 2017 11:49

Last Modified:

07 Mar 2019 10:02

Publisher DOI:

10.1111/jvh.12752

PubMed ID:

28685917

Additional Information:

Keiser and Rauch contributed equally to this work.

Uncontrolled Keywords:

HIV Direct-acting antivirals Hepatitis C virus Men who have sex with men treatment as prevention

BORIS DOI:

10.7892/boris.101876

URI:

https://boris.unibe.ch/id/eprint/101876

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