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
Katharina Kusejko, Luisa Salazar‐Vizcaya, Cyril Shah, M Stöckle, Charles Béguelin, Patrick Schmid, Marie Ongaro, Katharine Darling, Enos Bernasconi, Andri Rauch, Roger D. Kouyos, Huldrych F. Günthard, Jürg Böni, Jan Fehr, Dominique L. Braun, Swiss HIV Cohort Study, Irène A. Abela, Karoline Aebi‐Popp, A Anagnostopoulos, M Battegay, Enos Bernasconi, Dominique L. Braun, H C Bucher, Alexandra Calmy, Matthias Cavassini, Angela Ciuffi, G Dollenmaier, Matthias Egger, Luigia Elzi, Jan Fehr, Jacques Fellay, Hansjakob Furrer, Christoph A. Fux, Huldrych F. Günthard, Anna Hachfeld, David Haerry, Barbara Hasse, Hans H. Hirsch, Marc Hoffmann, Irène Hösli, M Huber, Christian R. Kahlert, Laurent Kaiser, Olivia Keiser, Thomas Klimkait, Roger D. Kouyos, Helen Kovari, Katharina Kusejko, G Martinetti, Begoña Martínez de Tejada, Catia Marzolini, Karin J. Metzner, N Müller, Johannes Nemeth, Dunja Nicca, P Paioni, G Pantaleo, Matthieu Perreau, Andri Rauch, Patrick Schmid, Roberto F. Speck, M Stöckle, Philip Tarr, Alexandra Trkola, Gilles Wandeler, Sabine Yerly
Abstract
BACKGROUND: The Swiss HCVree Trial (NCT02785666) was conducted in 2015-2017 with the goal of implementing a population-based systematic hepatitis C virus (HCV) micro-elimination program among men who have sex with men (MSM) with human immunodeficiency virus (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] [.17, .55]) in 2017 to 0.19/100 py (95% CI [.09, .39]) in 2019. CONCLUSIONS: A systematic HCV RNA-based screening among MSM with HIV conducted 2 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 with HIV in Switzerland. CLINICAL TRIALS REGISTRATION: NCT02785666.