Interventions to reduce acute hepatitis C virus in HIV-positive MSM. Issue 1 (February 2020)

• Record Type: Journal Article
• Authors: Elliott, Tamara; Cooke, Graham S.; Garvey, Lucy
• Is Part Of: Current opinion in infectious diseases. Volume 33:Issue 1(2020)
• Publication Date: 2020-02
• Subjects: direct acting antivirals -- hepatitis C virus -- HIV; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Review Literature -- Periodicals; 616.905
• DOI: 10.1097/QCO.0000000000000614
• Languages: English
• ISSNs: 0951-7375

Abstract

Abstract : Purpose of review: The WHO has set ambitious targets for hepatitis C virus (HCV) elimination by 2030. In this review, we explore the possibility of HCV micro-elimination in HIV-positive (+) MSM, discussing strategies for reducing acute HCV incidence and the likely interventions required to meet these targets. Recent findings: With wider availability of directly acting antivirals (DAAs) in recent years, reductions in acute HCV incidence have been reported in some cohorts of HIV+ MSM. Recent evidence demonstrates that treatment in early infection is well tolerated, cost effective and may reduce the risk of onward transmission. Modelling studies suggest that to reduce incidence, a combination approach including behavioural interventions and access to early treatment, targeting both HIV+ and negative high-risk groups, will be required. HCV vaccine trials have not yet demonstrated efficacy in human studies, however phase one and two studies are ongoing. Summary: Some progress towards the WHO HCV elimination targets has been reported. Achieving sustained HCV elimination is likely to require a combination approach including early access to DAAs in acute infection and reinfection, validated and reproducible behavioural interventions and an efficacious HCV vaccine.