High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis

Boyd, Anders; Vries, Henry J. C. de; Koopsen, Jelle; Deug, Febe; Heidenrijk, Michiel; Prins, Maria; Reiss, Peter; Valk, Marc van der; Bergen, Jan E. A. M. van; Bree, Godelieve J. de; Brokx, P. A.; Davidovich, Udi; Geerlings, Suzanne E.; Hoornenborg, Elske; Oomen, Akash T; Sighem, Ard van; Zuilhof, Wim; Bruinderink, M.L. Groot; Achterbergh, Roel C A; Agtmael, Michiel A. van; Ananworanich, Jintanat; Beek, Diederik van de; Berk, Guido E.L. van den; Bezemer, Daniela; Bijnen, Arjan Van; Blok, W; Bogers, Saskia J; Bomers, Marije K.; Boucher, Charles A.; Brokking, Wilma; Burger, David M.; Brinkman, Kees; Brinkman, N.; Bruin, Marijn de; Bruisten, Sylvia M.; Coyer, Liza; Crevel, Reinout van; Daans, Ceranza G.; Dellemann, L.; Dijkstra, Maartje; Duijnhoven, Yvonne THP van; Eeden, Arne van; Elsenburg, L.; Elshout, Mark A M van den; Ester, Carmen; Ersan, E.; Felipa, P. E. V.; Frissen, P. H. J.; Geijtenbeek, Teunis B. H.; Godfried, Mieke H.; Gool, J. van; Goorhuis, Abraham; Groot, Marco R. de; Hankins, Catherine; Heijnen, A.; Hillebregt, Mariska; Hogewoning, Arjan; Hommenga, M.; Hovius, Joppe W.; Janssen, Y. J. H.; Jong, K. De; Jongen, Vita W; Kootstra, Neeltje A.; Koup, Richard A.; Kroon, F.P.; Laar, T.J.W. van de; Lauw, Fanny N.; Leeuwen, M.M. van; Lettinga, Kamilla D.; Linde, Ineke; Loomans, Dominique; Meer, J.T. van der; Mouhebati, T.; Mulder, Barbara J.M.; Mulder, J.; Nellen, F.J.B.; Nijsters, A.; Nobel, H.; Oostvogel, Paul M.; Coul, Eline Op de; Peters, Erica J.; Peters, Inga; Poll, T. van der; Ratmann, Oliver; Rokx, Casper; Rooijen, Martijn S. van; Loeff, Maarten F. Schim van der; Schoute, W.E.M.; Sonder, Gerard J.B.; Veenstra, J.; Verbon, Annelies; Verdult, F.; Vocht, J. de; Vries, Henry Jc de; Vrouenraets, S. M. E.; Vugt, Michèle van; Wiersinga, W. Joost; Wit, Ferdinand W; Woittiez, Lycke R; Zaheri, S.; Zantkuijl, Paul; Zelm, Menno C. van; Żakowicz, Anna; Zimmermann, Hanne M L

doi:10.1016/j.jhep.2019.11.022

Cited by 52 publications

(57 citation statements)

References 42 publications

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“…Enrolment in HIV pre‐exposure prophylaxis (PrEP) programmes might reduce HCV incidence due to a reduction in risky behaviour [34], but they do not seem to achieve it, probably because HIV‐infected MSM and HIV‐negative MSM using PrEP share similar risk practices [35]. In fact, a recent study in a cohort of HIV‐negative MSM using PrEP in the Netherlands reported high IR of RAHC and of HCV reinfection, similar to the rates that we have found herein [36]. Mass screening at population level and linkage to care, with fast access to therapy for those with active HCV infection, is feasible, and it could be more successful than behavioural interventions, as proved with treatment‐as‐prevention for HIV infection [37].…”

Section: Discussionsupporting

confidence: 54%

Incidence of recently acquired hepatitis C virus infection among HIV‐infected patients in southern Spain

et al. 2020

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Objectives Spain is close to HCV microelimination, so rates of recently acquired HCV infection (RAHC) should decrease. Nowadays, men who have sex with men (MSM) carry the highest risk of HCV acquisition. Our aim was to estimate the incidence of and the factors associated with RAHC, together with reinfection rates, among patients sexually infected by HIV. Methods Primary RAHC infection was diagnosed when anti‐HCV antibody seroconversion was documented. In anti‐HCV positive patients, initially without HCV viraemia, a diagnosis of reinfection was established if plasma HCV RNA was detected. Results All 350 patients tested negative for anti‐HCV at baseline and had at least one follow‐up visit. Among them, there were 16 RAHC cases from 2016 to 2019. RAHC incidence rates [IR (95% confidence interval, CI)] per 100 person‐years were 3.77 (0.5–12.9) in 2016, 1.85 (0.6–4.3) in 2017, 1.49 (0.4–3.8) in 2018 and 1.98 (0.6–4.5) in 2019. Only previous sexually transmitted infections [incidence rate ratio (IRR) = 18.23, 95% CI: 1.93–172.1; P = 0.011], male sex (IRR = 8.33, 95% CI: 1.38–54.15; P = 0.026) and sharing chem‐sex drugs (IRR: 4.93, 95% CI: 1.17–20.76; P = 0.030), were independently associated with RAHC. Four out of 42 (9.5%) patients became reinfected. Conclusions The incidence of RAHC among HIV‐infected patients showed a decrease after 2016, although a lower but steady incidence of residual cases still remains. HCV reinfections showed a similar pattern. New infections were associated with sharing chem‐sex drugs among MSM.

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Section: Discussionsupporting

confidence: 54%

Incidence of recently acquired hepatitis C virus infection among HIV‐infected patients in southern Spain

et al. 2020

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“…26 MSM who do not have HIV who use pre-exposure prophylaxis against HIV have also witnessed high incidence of HCV infection. 27 Phylogenetic evidence suggests clustering of these HCV strains with those from MSM with HIV, but specific risk behaviours are known to be inconsistent within clusters. 28 Studies are needed to find out whether MSM who do not have HIV are a relevant source of undiagnosed HCV.…”

Section: Discussionmentioning

confidence: 99%

HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals: a retrospective cohort study

Laar¹,

Hollander²,

Boerekamps³

et al. 2021

The Lancet HIV

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“…Details of STI screening and laboratory procedures have been described previously [ 22 , 23 , 24 ]. In short, participants were screened for HIV, syphilis and urogenital, anal and pharyngeal chlamydia and gonorrhoea at three‐monthly study visits [ 20 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…HCV testing frequency was increased to six‐monthly starting May 2017 [ 20 ]. HCV testing in AMPrEP (anti‐HCV and HCV RNA if antibodies were present) was performed every 12 months until December 2016, after which testing was done bi‐annually [ 24 , 25 ]. Additional HCV testing in AMPrEP was performed in case of partner notification or clinical indication.…”

Section: Methodsmentioning

confidence: 99%

Choosing event‐driven and daily HIV pre‐exposure prophylaxis – data from two European PrEP demonstration projects among men who have sex with men

et al. 2021

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Introduction Daily and event‐driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event‐driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence. Methods We analysed pooled data from two prospective cohort studies among MSM: Be‐PrEP‐ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three‐monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018. Results and discussion We included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94). Conclusions A quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered.

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High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis

Cited by 52 publications

References 42 publications

Incidence of recently acquired hepatitis C virus infection among HIV‐infected patients in southern Spain

Incidence of recently acquired hepatitis C virus infection among HIV‐infected patients in southern Spain

HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals: a retrospective cohort study

Choosing event‐driven and daily HIV pre‐exposure prophylaxis – data from two European PrEP demonstration projects among men who have sex with men

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