Increased treatment of MSM leads to decrease in acute HCV in the Netherlands

SEATTLE — Incidence rates of acute hepatitis C virus are expected to decrease substantially over the coming years in the Netherlands, according to a speaker here.

The decrease was predicted due to the rapid uptake of patients, particularly HIV-positive men who have sex with men, receiving prompt treatment after direct-acting antiviral agents became universally available in 2016.

“MSM with a chronic hepatitis C infection ... can infect their sex partners and therefore it can be expected that if we treat MSM patients with hepatitis C as soon as they’re diagnosed, that this will reduce new infections,” Bart Rijnders, MD, PhD, associate professor in infectious diseases at the university hospital Erasmus MC in Rotterdam, the Netherlands, said at the Conference on Retroviruses and Opportunistic Infections (CROI) 2017.

Rijnders and colleagues reviewed data from 17 HIV treatment centers geographically spread across the Netherlands. These centers treat approximately 80% of all Dutch HIV-positive MSM.

In 2014, before DAA availability, there were 93 acute HCV cases in 8,290 person-years of follow-up from these centers (11.2/1,000 PYFU; 95% CI, 9.1-13.7). In 2016, the first year after DAA availability, there were 49 cases in 8,961 person-years of follow-up (5.5/1000 PYFU; 95% CI, 4.1-7.2). This represents a 52% decrease in the incidence of new infections.

“Within 14 months after these drugs became available to all, 76% HIV-positive MSM in the Netherlands were cured of their HCV infection,” Rijnders said and it seems like this very rapid treatment uptake also prevents new HCV transmissions. “So that’s really good news, because by treating all the patients, you also prevent new infections. And actually, in the long end, you may save money by preventing these new infections that you then don’t have to treat.” – by Talitha Bennett

References: Rijnders B, et al. Abstract 137LB. Presented at: The Conference on Retroviruses and Opportunistic Infections 2017; Feb. 13-16, 2017; Seattle.

Disclosure: Rijnders reports receiving research grants and travel grants from Merck and Gilead Sciences.

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