HIV-HCV coinfection eradication possible in France by 2026

SEATTLE — Researchers used model projection to predict that direct-acting antiviral agent-based treatments could nearly eradicate hepatitis C virus-HIV coinfection in France within the next decade, according to a speaker here.

Victor Virlogeux and colleagues developed their model based on epidemiology data from the French DatAIDS cohort and from observed incidence, prevalence and treatment coverage of HIV-HCV patients between 2012 and 2015. Figures of undiagnosed individuals were estimated with a previously published model from 2014.

They identified eight risk groups, including high-risk men who have sex with men, low-risk MSM, heterosexual men and women, intravenous drug users and patients with other risk factors.

The researchers estimated that 156,811 patients (131,861 under care) in France were infected with HIV and 7,939 (7,216 under care) of those had an active HCV coinfection with a detectable serum RNA. If the annual treatment coverage rate of 30% (observed rate in 2015) remains stable, active HCV prevalence among patients under care is predicted to decrease from 5.1% to 1.8% in 2021 and 1.1% in 2026 for most risk groups.

The model’s prediction for the high-risk MSM group, however, showed a decrease from 7% in 2016 to 6.4% in 2021 and 6.3% in 2026, while the number of coinfected high-risk MSM is expected to increase from 719 in 2016 to 840 in 2026. If annual treatment coverage were increased to 50% or 70% per year, the HCV prevalence for this risk group would decrease to 3.3% or 1.9% in 2021 and to 2.3% or 1.2% in 2026, respectively.

“HIV-HCV coinfections are predicted to significantly decrease over the next decade in almost all risk groups, except for high-risk MSM,” Virlogeux said in a press conference. “In these risk groups, to achieve a further HCV eradication, we need to target behavioral risk reduction, to do regular HIV screening in all MSM risk groups, to do HCV RNA testing in cured patients, to maintain the HCV treatment coverage at more than 30%, to study the HCV risk of transmission from HIV-negative patients to HIV-positive patients and to target the undiagnosed patients for engagement in care.” – by Talitha Bennett

References: Virlogeux V, et al. Abstract 135. Presented at: The Conference on Retroviruses and Opportunistic Infections 2017; Feb. 13-16, 2017; Seattle, Washington.

Disclosure: Virlogeux reports no relevant financial disclosures.

Editor’s Note: This article has been updated with clarifications from the presenter.