Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy

Anne  Boerekamps; Guido E. L. van den Berk; Fanny N. Lauw; E.M.S. Leyten; M. E. van Kasteren; Arne van Eeden; Dirk Posthouwer; Mark A. A. Claassen; Anton S. Dofferhof; D.W.M. Verhagen; Wouter F. W. Bierman; K.D. Lettinga; F.P. Kroon; C. E. Delsing; Paul H. P. Groeneveld; R. Soetekouw; E.J.G. Peters; Sebastiaan J. Hullegie; Stephanie Popping; D.A.M.C. van de Vijver; C.A. Boucher; Joop E. Arends; Bart J. A. Rijnders

doi:10.1093/cid/cix1007

Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy

Anne Boerekamps^*, Guido E. L. van den Berk, Fanny N. Lauw, E.M.S. Leyten, M. E. van Kasteren, Arne van Eeden, Dirk Posthouwer, Mark A. A. Claassen, Anton S. Dofferhof, D.W.M. Verhagen, Wouter F. W. Bierman, K.D. Lettinga, F.P. Kroon, C. E. Delsing, Paul H. P. Groeneveld, R. Soetekouw, E.J.G. Peters, Sebastiaan J. Hullegie, Stephanie Popping, D.A.M.C. van de VijverC.A. Boucher, Joop E. Arends, Bart J. A. Rijnders

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background. Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIVpositive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.

Methods. Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years.

Results. The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI,.35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation.

Conclusions. Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.

Original language	English
Pages (from-to)	1360-1365
Number of pages	6
Journal	Clinical Infectious Diseases
Volume	66
Issue number	9
DOIs	https://doi.org/10.1093/cid/cix1007
Publication status	Published - 1 May 2018

Keywords

Incidence
hepatitis C
acute Hepatitis C
direct acting antiviral therapy
men having sex with men
HIV-INFECTED MSM
SEXUALLY-TRANSMITTED INFECTION
REINFECTION INCIDENCE
TRANSMISSION
NETHERLANDS
EPIDEMIC

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10.1093/cid/cix1007

Cite this

Boerekamps, A., van den Berk, G. E. L., Lauw, F. N., Leyten, E. M. S., van Kasteren, M. E., van Eeden, A., Posthouwer, D., Claassen, M. A. A., Dofferhof, A. S., Verhagen, D. W. M., Bierman, W. F. W., Lettinga, K. D., Kroon, F. P., Delsing, C. E., Groeneveld, P. H. P., Soetekouw, R., Peters, E. J. G., Hullegie, S. J., Popping, S., ... Rijnders, B. J. A. (2018). Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy. Clinical Infectious Diseases, 66(9), 1360-1365. https://doi.org/10.1093/cid/cix1007

@article{9d5aa495be4f48d68cb55880c7522647,

title = "Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy",

abstract = "Background. Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIVpositive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods. Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years.Results. The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI,.35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation.Conclusions. Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.",

keywords = "Incidence, hepatitis C, acute Hepatitis C, direct acting antiviral therapy, men having sex with men, HIV-INFECTED MSM, SEXUALLY-TRANSMITTED INFECTION, REINFECTION INCIDENCE, TRANSMISSION, NETHERLANDS, EPIDEMIC",

author = "Anne Boerekamps and {van den Berk}, {Guido E. L.} and Lauw, {Fanny N.} and E.M.S. Leyten and {van Kasteren}, {M. E.} and {van Eeden}, Arne and Dirk Posthouwer and Claassen, {Mark A. A.} and Dofferhof, {Anton S.} and D.W.M. Verhagen and Bierman, {Wouter F. W.} and K.D. Lettinga and F.P. Kroon and Delsing, {C. E.} and Groeneveld, {Paul H. P.} and R. Soetekouw and E.J.G. Peters and Hullegie, {Sebastiaan J.} and Stephanie Popping and {van de Vijver}, D.A.M.C. and C.A. Boucher and Arends, {Joop E.} and Rijnders, {Bart J. A.}",

year = "2018",

month = may,

day = "1",

doi = "10.1093/cid/cix1007",

language = "English",

volume = "66",

pages = "1360--1365",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "9",

}

Boerekamps, A, van den Berk, GEL, Lauw, FN, Leyten, EMS, van Kasteren, ME, van Eeden, A, Posthouwer, D, Claassen, MAA, Dofferhof, AS, Verhagen, DWM, Bierman, WFW, Lettinga, KD, Kroon, FP, Delsing, CE, Groeneveld, PHP, Soetekouw, R, Peters, EJG, Hullegie, SJ, Popping, S, van de Vijver, DAMC, Boucher, CA, Arends, JE & Rijnders, BJA 2018, 'Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy', Clinical Infectious Diseases, vol. 66, no. 9, pp. 1360-1365. https://doi.org/10.1093/cid/cix1007

Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy. / Boerekamps, Anne ; van den Berk, Guido E. L.; Lauw, Fanny N. et al.
In: Clinical Infectious Diseases, Vol. 66, No. 9, 01.05.2018, p. 1360-1365.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy

AU - Boerekamps, Anne

AU - van den Berk, Guido E. L.

AU - Lauw, Fanny N.

AU - Leyten, E.M.S.

AU - van Kasteren, M. E.

AU - van Eeden, Arne

AU - Posthouwer, Dirk

AU - Claassen, Mark A. A.

AU - Dofferhof, Anton S.

AU - Verhagen, D.W.M.

AU - Bierman, Wouter F. W.

AU - Lettinga, K.D.

AU - Kroon, F.P.

AU - Delsing, C. E.

AU - Groeneveld, Paul H. P.

AU - Soetekouw, R.

AU - Peters, E.J.G.

AU - Hullegie, Sebastiaan J.

AU - Popping, Stephanie

AU - van de Vijver, D.A.M.C.

AU - Boucher, C.A.

AU - Arends, Joop E.

AU - Rijnders, Bart J. A.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background. Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIVpositive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods. Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years.Results. The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI,.35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation.Conclusions. Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.

AB - Background. Direct-acting antivirals (DAAa) cure hepatitis C virus (HCV) infections in 95% of infected patients. Modeling studies predict that universal HCV treatment will lead to a decrease in the incidence of new infections but real-life data are lacking. The incidence of HCV among Dutch human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAAs became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIVpositive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods. Two prospective studies of treatment for acute HCV infection enrolled patients in 17 Dutch HIV centers, having 76% of the total HIV-positive MSM population in care in the Netherlands. Patients were recruited in 2014 and 2016, the years before and after unrestricted DAA availability. We compared the HCV incidence in both years.Results. The incidence of acute HCV infection decreased from 93 infections during 8290 person-years of follow-up (PYFU) in 2014 (11.2/1000 PYFU; 95% confidence interval [CI], 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000 PYFU; 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% CI,.35-.69). Simultaneously, a significant increase in the percentage positive syphilis (+2.2%) and gonorrhea (+2.8%) tests in HIV-positive MSM was observed at sexual health clinics across the Netherlands and contradicts a decrease in risk behavior as an alternative explanation.Conclusions. Unrestricted DAA availability in the Netherlands was followed by a 51% decrease in acute HCV infections among HIV-positive MSM.

KW - Incidence

KW - hepatitis C

KW - acute Hepatitis C

KW - direct acting antiviral therapy

KW - men having sex with men

KW - HIV-INFECTED MSM

KW - SEXUALLY-TRANSMITTED INFECTION

KW - REINFECTION INCIDENCE

KW - TRANSMISSION

KW - NETHERLANDS

KW - EPIDEMIC

U2 - 10.1093/cid/cix1007

DO - 10.1093/cid/cix1007

M3 - Article

C2 - 29186320

SN - 1058-4838

VL - 66

SP - 1360

EP - 1365

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 9

ER -