Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;25(8):967-975.
doi: 10.1111/hiv.13651. Epub 2024 May 29.

Recently acquired HCV infection in men who have sex with men in Germany in the direct-acting antivirals era and during the COVID-19 pandemic

Patrick Ingiliz  1   2 , Thomas Lutz  3 , Knud Schewe  4 , Axel Baumgarten  1 , Ivanka Krznaric  1 , Stefan Mauss  5 , Stefan Christensen  6   7 , Markus Bickel  3 , Axel J Schmidt  8 , Michael Sabranski  4 , Feng He  9 , Sonia Jain  9 , Nastasha K Martin  10 , Jürgen K Rockstroh  11   12 , Christoph Boesecke  11   12
Affiliations

Recently acquired HCV infection in men who have sex with men in Germany in the direct-acting antivirals era and during the COVID-19 pandemic

Patrick Ingiliz et al. HIV Med. 2024 Aug.

Abstract

Introduction: Direct-acting antivirals (DAAs) are key to eliminating hepatitis C virus (HCV). In men who have sex with men (MSM) with HIV co-infection, recently acquired HCV infection is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates.

Methods: The cohort included MSM with recently acquired HCV infection from 2014 to 2021. The patients' demographic, clinical, behavioural, and laboratory data and treatment and reinfection outcomes were documented.

Results: A total of 237 men with recently acquired HCV infection were included: 216 (91%) had HIV. The median age was 46 years (interquartile range [IQR] 39-52), and the median CD4 count was 660/mm3 (IQR 527-835). The annual incidence of recently acquired HCV remained between 0.28% and 0.43% but dropped to 0.02% in 2021 during the COVID pandemic, almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95% confidence interval 12.6-18.8), and reinfection was associated with the use of crystal methamphetamine (p = 0.032) and ketamine (p = 0.042). In total, 31.3% had multiple reinfections, and four reinfections occurred in users of pre-exposure prophylaxis.

Conclusions: High treatment and cure rates did not lead to HCV elimination. A change in sexual behaviour, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As recently acquired HCV is prevalent in MSM with and without HIV, surveillance is necessary to consolidate elimination goals.

Keywords: DAA; HCV incidence; WHO elimination goals; chemsex; reinfection.

PubMed Disclaimer

References

REFERENCES

    1. World Health Organization. Global Health Strategy on Viral Hepatitis 2016–2021. World Health Organization; 2016.
    1. Blach S. Updated evaluation of global progress towards HBV and HCV elimination, preliminary data through 2021. Paper presented at: The Liver Meeting 2022: American Association for the Study of Liver Diseases (AASLD); Abstract 45, November 7, 2022.
    1. Tergast TL, Blach S, Tacke F, et al. Updated epidemiology of hepatitis C virus infections and implications for hepatitis C virus elimination in Germany. J Viral Hepat. 2022;29(7):536‐542.
    1. Lazarus JV, Safreed‐Harmon K, Thursz MR, et al. The micro‐elimination approach to eliminating hepatitis C: strategic and operational considerations. Semin Liver Dis. 2018;38(3):181‐192.
    1. Hosseini‐Hooshyar S, Hajarizadeh B, Bajis S, et al. Hepatitis C reinfection risk following successful therapy among people living with HIV: a global systematic review, meta‐analysis, and meta‐regression. Lancet HIV. 2022;9(6):e414‐e427. doi:10.1016/S2352‐3018(22)00077‐7

Publication types

Substances