New cases of hepatitis C virus (HCV) amongst HIV-positive men who have sex with men (MSM) have fallen by nearly 78 per cent in London and Brighton in recent years, according to a study published in the journal Clinical Infectious Diseases.
The analysis examined data from more than 9000 men at risk for HCV at four centres in London and one in Brighton – St Mary’s Hospital, Royal Free NHS Trust, Mortimer Market Centre, Barts Health NHS Trust and Brighton & Sussex University Hospitals NHS Trust. The data showed that 378 cases were diagnosed between July 2013 and June 2018, comprising 292 first infections and 86 reinfections.
The incidence of acute HCV in MSM living with HIV peaked in 2015 at 14.57/1000 person-years of follow-up (95% CI, 10.95-18.20). Rates fell to 4.63/1000 person-years of follow-up in 2018 (95% CI, 2.60-6.67). Time from diagnosis to starting of treatment declined from 29.8 months in 2013 to 3.7 months in 2018.
The findings suggest there has been a 78 per cent reduction in the incidence of first HCV episode and a 68 per cent reduction in overall HCV incidence since the epidemic peak in 2015. This coincides with wider access to direct-acting antivirals in England.
Commenting on the findings, Professor Graham S Cooke, NIHR Professor of Infectious Diseases at Imperial College London and co-author of the paper, said: "This study builds on our previous work and it is encouraging to see that our results have been repeated in a larger cohort of patients and in more areas in the UK. It is great news that following our study NHS England has changed its guidelines and patients will have greater access to DAA tablets through NHS services. This will have a positive impact on outcomes for patients as we work towards eliminating this disease."