New cases of hepatitis C among HIV-positive men in London have dropped by approximately 70 per cent in recent years.
A retrospective cohort study, presented at the Conference on Retroviruses and Opportunistic Infections in Seattle yesterday (Wednesday 6 March), suggests greater access to direct acting antivirals (DAAs) and earlier treatment of acute cases are working.
The study was conducted at three London HIV clinics (Royal Free and St Mary's Hospitals, Mortimer Market) between July 2013 and June 2018. During each six-month period, data were collected on number of first acute HCV diagnoses; re-infections; denominator of HIV-positive men who have sex with men (MSM) under active follow up; and access to early treatment.
A total of 293 acute HCV infections were identified - 246 first infections and 47 re-infections.
Incidence of first HCV episode peaked at 17.72/1,000 (95% CI 12.81-22.64) HIV+MSM person-years of follow-up (PYFU) in 2015. DAA treatment became widely available in late 2015 and by 2018, rates fell to 4.64 (95% CI 2.53-7.78).
Although re-infection rates increased from 9 to 16 per cent during the study period, the data show that there been a 74 per cent reduction in incidence of first HCV infection and 62 per cent reduction of overall HCV incidence in HIV+MSM since the epidemic peak of 2015.