Sustained effect on hepatitis C elimination among men who have sex with men in the Swiss HIV Cohort Study: A systematic re-screening for hepatitis C RNA two years following a nation-wide elimination program.

Kusejko, Katharina; Salazar-Vizcaya, Luisa; Shah, Cyril; Stöckle, Marcel; Béguelin, Charles; Schmid, Patrick; Ongaro, Marie; Darling, Katherine; Bernasconi, Enos; Rauch, Andri; Kouyos, Roger D; Günthard, Huldrych F; Böni, Jürg; Fehr, Jan S; Braun, Dominique L (2022). Sustained effect on hepatitis C elimination among men who have sex with men in the Swiss HIV Cohort Study: A systematic re-screening for hepatitis C RNA two years following a nation-wide elimination program. Clinical infectious diseases, 75(10), pp. 1723-1731. Oxford University Press 10.1093/cid/ciac273

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INTRODUCTION

The Swiss HCVree Trial (NCT02785666) was conducted in 2015-2017 with the goal of implementing a population-based systematic hepatitis C (HCV) micro-elimination program among men who have sex with men (MSM) living with HIV enrolled in the Swiss HIV Cohort Study (SHCS). The trial led to a 91% and 77% decline of HCV prevalence and incidence, respectively. The long-term effect of this HCV micro-elimination program is yet to be explored.

METHODS

All MSM enrolled in the SHCS were screened for HCV RNA using stored plasma samples obtained in 2019, termed "Swiss HCVree Post" screen. The incidence of HCV infection over time was assessed using additional information on HCV testing routinely collected in the SHCS. Characteristics of participants with replicating HCV infection were analyzed.

RESULTS

The point-prevalence of "Swiss HCVree Post" (N = 4641) was 0.6%, reflecting a decline of 48% compared to the end of the Swiss HCVree Trial where the prevalence was 1.2%. Further, the incidence of HCV among MSM in the SHCS declined from 0.31/100 person-years (py) (95%-confidence interval (CI) = [0.17,0.55]) in 2017 to 0.19/100 py (95%-CI = [0.09,0.39]) in 2019.

CONCLUSION

A systematic HCV RNA-based screening among MSM living with HIV conducted two years after the Swiss HCVree Trial revealed a sustained effect and further decline of the prevalence and incidence of replicating HCV infection. This indicates that the Swiss HCVree Trial was successful in curbing the HCV epidemic among MSM living with HIV in Switzerland.

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