Titre
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.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Salazar-Vizcaya, L.
Auteure/Auteur
Kouyos, R.D.
Auteure/Auteur
Fehr, J.
Auteure/Auteur
Braun, D.
Auteure/Auteur
Estill, J.
Auteure/Auteur
Bernasconi, E.
Auteure/Auteur
Delaloye, J.
Auteure/Auteur
Stöckle, M.
Auteure/Auteur
Schmid, P.
Auteure/Auteur
Rougemont, M.
Auteure/Auteur
Wandeler, G.
Auteure/Auteur
Günthard, H.F.
Auteure/Auteur
Keiser, O.
Auteure/Auteur
Rauch, A.
Auteure/Auteur
Groupes de travail
Swiss HIV Cohort Study
Liens vers les personnes
Liens vers les unités
ISSN
1365-2893
Statut éditorial
Publié
Date de publication
2018-01
Volume
25
Numéro
1
Première page
10
Dernière page/numéro d’article
18
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Clinical Trial, Phase III ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
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 (i) universal DAA treatment (pangenotypic intervention) and (ii) 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.
Sujets
PID Serval
serval:BIB_5C9D53A95FAF
PMID
Date de création
2017-08-04T13:13:17.381Z
Date de création dans IRIS
2025-05-20T16:15:51Z