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. van den Berk, Fanny N. Lauw, Eliane M. Leyten, Marjo E. van Kasteren, Arne van Eeden, Dirk Posthouwer, Mark A. Claassen, Anton S. Dofferhoff, Dominique W. M. Verhagen, Wouter F. Bierman, Kamilla D. Lettinga, Frank P. Kroon, Corine E. Delsing, Paul H. Groeneveld, Robert Soetekouw, Edgar J. Peters, Sebastiaan J. Hullegie, Stephanie Popping, David A. M. C. van de Vijver & 3 others Charles A. Boucher, Joop E. Arends, Bart J. Rijnders

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Direct acting antivirals (DAA) cure 95% of patients infected with hepatitis C (HCV). 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 HIV-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAA became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.

Methods: Two prospective acute HCV treatment studies 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 year preceding and following unrestricted DAA availability. We compared the HCV incidence in both years.

Results: The acute HCV incidence decreased from 93 infections during 8290 person years of follow up in 2014 (11.2/1000 PYFU, 95% CI 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000, 95% CI 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% C.I. 0.35-0.69). 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 languageEnglish
Pages (from-to)1360-1365
JournalClinical Infectious Diseases
Volume66
Issue number9
DOIs
Publication statusPublished - 1 May 2018

Cite this

Boerekamps, Anne ; van den Berk, Guido E. ; Lauw, Fanny N. ; Leyten, Eliane M. ; van Kasteren, Marjo E. ; van Eeden, Arne ; Posthouwer, Dirk ; Claassen, Mark A. ; Dofferhoff, Anton S. ; Verhagen, Dominique W. M. ; Bierman, Wouter F. ; Lettinga, Kamilla D. ; Kroon, Frank P. ; Delsing, Corine E. ; Groeneveld, Paul H. ; Soetekouw, Robert ; Peters, Edgar J. ; Hullegie, Sebastiaan J. ; Popping, Stephanie ; van de Vijver, David A. M. C. ; Boucher, Charles A. ; Arends, Joop E. ; Rijnders, Bart J. / Declining Hepatitis C Virus (HCV) Incidence in Dutch Human Immunodeficiency Virus-Positive Men Who Have Sex With Men After Unrestricted Access to HCV Therapy. In: Clinical Infectious Diseases. 2018 ; Vol. 66, No. 9. pp. 1360-1365.
@article{15cccc8b4443422a841b61ca5f1ba21e,
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 (DAA) cure 95{\%} of patients infected with hepatitis C (HCV). 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 HIV-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAA became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods: Two prospective acute HCV treatment studies 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 year preceding and following unrestricted DAA availability. We compared the HCV incidence in both years.Results: The acute HCV incidence decreased from 93 infections during 8290 person years of follow up in 2014 (11.2/1000 PYFU, 95{\%} CI 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000, 95{\%} CI 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95{\%} C.I. 0.35-0.69). 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",
author = "Anne Boerekamps and {van den Berk}, {Guido E.} and Lauw, {Fanny N.} and Leyten, {Eliane M.} and {van Kasteren}, {Marjo E.} and {van Eeden}, Arne and Dirk Posthouwer and Claassen, {Mark A.} and Dofferhoff, {Anton S.} and Verhagen, {Dominique W. M.} and Bierman, {Wouter F.} and Lettinga, {Kamilla D.} and Kroon, {Frank P.} and Delsing, {Corine E.} and Groeneveld, {Paul H.} and Robert Soetekouw and Peters, {Edgar J.} and Hullegie, {Sebastiaan J.} and Stephanie Popping and {van de Vijver}, {David A. M. C.} and Boucher, {Charles A.} and Arends, {Joop E.} and Rijnders, {Bart J.}",
year = "2018",
month = "5",
day = "1",
doi = "10.1093/cid/cix1007",
language = "English",
volume = "66",
pages = "1360--1365",
journal = "Clinical infectious diseases : an official publication of the Infectious Diseases Society of America",
issn = "1058-4838",
number = "9",

}

Boerekamps, A, van den Berk, GE, Lauw, FN, Leyten, EM, van Kasteren, ME, van Eeden, A, Posthouwer, D, Claassen, MA, Dofferhoff, AS, Verhagen, DWM, Bierman, WF, Lettinga, KD, Kroon, FP, Delsing, CE, Groeneveld, PH, Soetekouw, R, Peters, EJ, Hullegie, SJ, Popping, S, van de Vijver, DAMC, Boucher, CA, Arends, JE & Rijnders, BJ 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, 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.; Lauw, Fanny N.; Leyten, Eliane M.; van Kasteren, Marjo E.; van Eeden, Arne; Posthouwer, Dirk; Claassen, Mark A.; Dofferhoff, Anton S.; Verhagen, Dominique W. M.; Bierman, Wouter F.; Lettinga, Kamilla D.; Kroon, Frank P.; Delsing, Corine E.; Groeneveld, Paul H.; Soetekouw, Robert; Peters, Edgar J.; Hullegie, Sebastiaan J.; Popping, Stephanie; van de Vijver, David A. M. C.; Boucher, Charles A.; Arends, Joop E.; Rijnders, Bart J.

In: Clinical Infectious Diseases, Vol. 66, No. 9, 01.05.2018, p. 1360-1365.

Research output: Contribution to journalArticleAcademicpeer-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.

AU - Lauw, Fanny N.

AU - Leyten, Eliane M.

AU - van Kasteren, Marjo E.

AU - van Eeden, Arne

AU - Posthouwer, Dirk

AU - Claassen, Mark A.

AU - Dofferhoff, Anton S.

AU - Verhagen, Dominique W. M.

AU - Bierman, Wouter F.

AU - Lettinga, Kamilla D.

AU - Kroon, Frank P.

AU - Delsing, Corine E.

AU - Groeneveld, Paul H.

AU - Soetekouw, Robert

AU - Peters, Edgar J.

AU - Hullegie, Sebastiaan J.

AU - Popping, Stephanie

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

AU - Boucher, Charles A.

AU - Arends, Joop E.

AU - Rijnders, Bart J.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: Direct acting antivirals (DAA) cure 95% of patients infected with hepatitis C (HCV). 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 HIV-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAA became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods: Two prospective acute HCV treatment studies 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 year preceding and following unrestricted DAA availability. We compared the HCV incidence in both years.Results: The acute HCV incidence decreased from 93 infections during 8290 person years of follow up in 2014 (11.2/1000 PYFU, 95% CI 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000, 95% CI 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% C.I. 0.35-0.69). 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 (DAA) cure 95% of patients infected with hepatitis C (HCV). 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 HIV-positive men who have sex with men (MSM) has been high for >10 years. In 2015 DAA became available to all Dutch HCV patients and resulted in a rapid treatment uptake in HIV-positive MSM. We assessed whether this uptake was followed by a decrease in the incidence of HCV infections.Methods: Two prospective acute HCV treatment studies 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 year preceding and following unrestricted DAA availability. We compared the HCV incidence in both years.Results: The acute HCV incidence decreased from 93 infections during 8290 person years of follow up in 2014 (11.2/1000 PYFU, 95% CI 9.1-13.7) to 49 during 8961 PYFU in 2016 (5.5/1000, 95% CI 4.1-7.2). The incidence rate ratio of 2016 compared with 2014 was 0.49 (95% C.I. 0.35-0.69). 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

U2 - 10.1093/cid/cix1007

DO - 10.1093/cid/cix1007

M3 - Article

VL - 66

SP - 1360

EP - 1365

JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

SN - 1058-4838

IS - 9

ER -