RT Journal Article
T1 What is needed to achieve HCV microelimination among HIV-infected populations in Andalusia, Spain: a modeling analysis.
A1 Skaathun, Britt
A1 Borquez, Annick
A1 Rivero-Juarez, Antonio
A1 Mehta, Sanjay R
A1 Tellez, Francisco
A1 Castaño-Carracedo, Manuel
A1 Merino, Dolores
A1 Palacios, Rosario
A1 Macías, Juan
A1 Rivero, Antonio
A1 Martin, Natasha K
K1 Direct-acting antivirals
K1 HIV
K1 Hepatitis C virus
K1 Microelimination
K1 Prevention
AB Scale-up of hepatitis C virus (HCV) treatment for HIV/HCV coinfected individuals is occurring in Spain, the vast majority (> 85%) with a reported history of injecting drug use and a smaller population of co-infected men who have sex with men (MSM). We assess impact of recent treatment scale-up to people living with HIV (PLWH) and implications for achieving the WHO HCV incidence elimination target (80% reduction 2015-2030) among PLWH and overall in Andalusia, Spain, using dynamic modeling. A dynamic transmission model of HCV/HIV coinfection was developed. The model was stratified by people who inject drugs (PWID) and MSM. The PWID component included dynamic HCV transmission from the HCV-monoinfected population. The model was calibrated to Andalusia based on published data and the HERACLES cohort (prospective cohort of HIV/HCV coinfected individuals representing > 99% coinfected individuals in care in Andalusia). From HERACLES, we incorporated HCV treatment among diagnosed PLWH of 10.5%/year from 2004 to 2014, and DAAs at 33%/year from 2015 with 94.8% SVR. We project the impact of current and scaled-up HCV treatment for PLWH on HCV prevalence and incidence among PLWH and overall. Current treatment rates among PLWH (scaled-up since 2015) could substantially reduce the number of diagnosed coinfected individuals (mean 76% relative reduction from 2015 to 2030), but have little impact on new diagnosed coinfections (12% relative reduction). However, DAA scale-up to PWLH in 2015 would have minimal future impact on new diagnosed coinfections (mean 9% relative decrease from 2015 to 2030). Similarly, new cases of HCV would only reduce by a mean relative 29% among all PWID and MSM due to ongoing infection/reinfection. Diagnosing/treating all PLWH annually from 2020 would increase the number of new HCV infections among PWLH by 28% and reduce the number of new HCV infections by 39% among the broader population by 2030. Targeted scale-up of HCV treatment to PLWH can dramatically reduce prevalence among this group but will likely have little impact on the annual number of newly diagnosed HIV/HCV coinfections. HCV microelimination efforts among PWLH in Andalusia and settings where a large proportion of PLWH have a history of injecting drug use will require scaled-up HCV diagnosis and treatment among PLWH and the broader population at risk.
PB BioMed Central Ltd.
YR 2020
FD 2020-07-22
LK http://hdl.handle.net/10668/16071
UL http://hdl.handle.net/10668/16071
LA en
NO Skaathun B, Borquez A, Rivero-Juarez A, Mehta SR, Tellez F, Castaño-Carracedo M, et al. What is needed to achieve HCV microelimination among HIV-infected populations in Andalusia, Spain: a modeling analysis. BMC Infect Dis. 2020 Aug 8;20(1):588.
NO This study was funded by Gilead Sciences. The funder had no role in the analysis or presentation of the results. NM and AB were additionally supported by the National Institute for Drug Abuse [grant number R01 DA037773]. NM and BS had partial support from the University of California San Diego Center for AIDS Research (CFAR), a National Institute of Health (NIH) funded program [grant number P30 AI036214] which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA NIGMS, and NIDDK. NM was supported by the National Institute of Allergy and Infectious Diseases and National Institue for Drug Abuse [grant number R01 AI147490], and BS was supported by the National Institute for Drug Abuse [grant number K01DA049665].  This work was also supported by the Ministerio de Sanidad (RD12/0017/0012) integrated in the Plan Nacional de I + D + I, and cofinanced by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), the Fundación para la Investigación en Salud (FIS) del Instituto Carlos III (PI15/01017), and the Red de Investigación en SIDA de España ISCIII-RETIC (grant number: RD16/0025/0034). The views expressed are those of the authors and not necessarily those of the National Institutes of Health.
DS RISalud
RD Apr 9, 2025