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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals: a retrospective cohort study
The Lancet HIV, Volume 8, No. 2, Year 2021
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Description
Background: In the Netherlands, access to direct-acting antivirals (DAAs) against hepatitis C virus (HCV) has been unrestricted for chronic infection since 2015. We evaluated whether the nationwide incidence of HCV infections in individuals with HIV has changed since 2015. Methods: In this retrospective cohort study, data from the ATHENA cohort of people with HIV aged 18 years or older attending any of the 24 HIV treatment centres in the Netherlands between 2000 and 2019 were assessed. We used parametric proportional hazards models with a piecewise exponential survival function to model HCV primary infection and reinfection incidence per 1000 person-years. Findings: Of the 23 590 individuals without previous HCV infection, 1269 cases of HCV primary infection were documented (incidence 5·2 per 1000 person-years [95% CI 5·0–5·5]). The highest incidence was observed in men who have sex with men (MSM; 7·7 per 1000 person-years [7·3–8·2]) and was lower in people who inject drugs (PWID; 1·7 per 1000 person-years [0·7–4·1]) and other key populations (1·0 per 1000 person-years [0·8–1·2]). In MSM, incidence increased in 2007 to 14·3 per 1000 person-years and fluctuated between 8·7 and 13·0 per 1000 person-years from 2008 to 2015. In 2016, incidence declined to 6·1 cases per 1000 person-years and remained steady between 4·1 and 4·9 per 1000 person-years from 2017 to 2019. Of the 1866 individuals with a previous HCV infection, 274 reinfections were documented (incidence 26·9 per 1000 person-years [95% CI 23·9–30·3]). The highest incidence rate was observed in MSM (38·5 per 1000 person-years [33·9–43·7]) and was lower in PWID (10·9 per 1000 person-years [3·5–33·8]) and other key populations (8·9 per 1000 person-years [6·3–12·5]). In MSM, reinfection incidence fluctuated between 38·0 and 88·9 per 1000 person-years from 2006 to 2015, reaching 55·6 per 1000 person-years in 2015. In 2016, reinfection incidence declined to 41·4 per 1000 person-years, followed by further decreases to 24·4 per 1000 person-years in 2017 and 11·4 per 1000 person-years in 2019. Interpretation: The sharp decline in HCV incidence in MSM with HIV shortly after restrictions on DAAs were lifted suggests a treatment-as-prevention effect. HCV incidence was already low in PWID and other groups before unrestricted access. Ongoing HCV transmission is occurring in MSM, as illustrated by a declining but high rate of reinfection, stressing the need for additional preventive measures. Funding: Dutch Ministry of Health, Welfare, and Sport. © 2021 Elsevier Ltd
Authors & Co-Authors
Smit, Colette
Netherlands, Amsterdam
Stichting Hiv Monitoring
Boyd, Anders C.
Netherlands, Amsterdam
Stichting Hiv Monitoring
Netherlands, Utrecht
Netherlands Public Health Service
Rijnders, Bart J.A.
Netherlands, Rotterdam
Erasmus Mc
Leyten, Eliane Madeleine Sophie
Netherlands, Leidschendam
Hmc
den Hollander, Jan G.
Netherlands, Rotterdam
Maasstad Ziekenhuis
Prins, Maria
Netherlands, Utrecht
Netherlands Public Health Service
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Arends, Joop E.A.
Netherlands, Utrecht
University Medical Center Utrecht
van der Valk, Marc
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Reiss, Peter
Netherlands, Amsterdam
Stichting Hiv Monitoring
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Geerlings, Suzanne Eugenie
Unknown Affiliation
Goorhuis, Abram
Unknown Affiliation
Hovius, Joppe Willem R.
Unknown Affiliation
van der Poll, Tom
Unknown Affiliation
Prins, Jan M.
Unknown Affiliation
van Vugt, Michèle V.
Unknown Affiliation
Wiersinga, Willem Joost
Unknown Affiliation
Wit, Ferdinand W.N.M.
Unknown Affiliation
Jurriaans, Suzanne
Unknown Affiliation
Back, Nicole K.T.
Unknown Affiliation
Zaaijer, Hans L.
Unknown Affiliation
Berkhout, Ben
Unknown Affiliation
Cornelissen, Marion T.E.
Unknown Affiliation
Wolthers, Katja C.
Unknown Affiliation
Peters, Edgar J.
Unknown Affiliation
Van Agtmael, Michiel A.
Unknown Affiliation
Autar, R. S.
Unknown Affiliation
Sigaloff, Kim Catherina Eve
Unknown Affiliation
Van Houdt, Robin
Unknown Affiliation
Jonges, Marcel
Unknown Affiliation
Stegeman, Jan Arend
Unknown Affiliation
Veenemans, Jacobien
Unknown Affiliation
Ammerlaan, Heidi S.M.
Unknown Affiliation
Berrevoets, Marvin A.H.
Unknown Affiliation
Brouwer, Annemarie E.
Unknown Affiliation
van Gorp, E. C.
Unknown Affiliation
Nouwen, Jan L.
Unknown Affiliation
Rokx, Casper
Unknown Affiliation
Verbon, Annelies
Unknown Affiliation
Boucher, Charles A.B.
Unknown Affiliation
Koopmans, Marion P.G.
Unknown Affiliation
van Nieuwkoop, Cees
Unknown Affiliation
Kroon, Frank P.
Unknown Affiliation
de Boer, Mark G.J.
Unknown Affiliation
Claas, Eric C.J.
Unknown Affiliation
Wessels, Els
Unknown Affiliation
Pontesilli, Oscar
Unknown Affiliation
Oude Lashof, Astrid M.L.
Unknown Affiliation
van Loo, Inge H.M.
Unknown Affiliation
van Vonderen, Marit G.A.
Unknown Affiliation
Kampschreur, Linda Martine
Unknown Affiliation
Delsing, Corine E.
Unknown Affiliation
Stalenhoef, Janneke Evelyne
Unknown Affiliation
van Crevel, Reinout
Unknown Affiliation
ter Hofstede, Hadewych J.M.T.
Unknown Affiliation
Hoogerwerf, Jacobien J.
Unknown Affiliation
Keuter, Monique M.
Unknown Affiliation
Rahamat-Langendoen, Janette C.
Unknown Affiliation
Stelma, Foekje F.
Unknown Affiliation
Burger, David Marinus
Unknown Affiliation
Claassen, Mathilda
Unknown Affiliation
Soetekouw, Robert
Unknown Affiliation
Bakker, Margreet E.G.
Unknown Affiliation
Kleinnijenhuis, Johanneke
Unknown Affiliation
Postma, Douwe F.
Unknown Affiliation
Stienstra, Ymkje
Unknown Affiliation
Boonstra, André
Unknown Affiliation
Hoepelman, Andy I.M.
Unknown Affiliation
Barth, Roos E.
Unknown Affiliation
Mudrikova, Tania
Unknown Affiliation
van Welzen, Berend Joost
Unknown Affiliation
Schuurman, Rob J.
Unknown Affiliation
Wensing, Annemarie Marie J.
Unknown Affiliation
Bezemer, Daniela O.
Unknown Affiliation
van Sighem, Ard I.
Unknown Affiliation
Hillebregt, Mariska M.J.
Unknown Affiliation
de Groot, Laura
Unknown Affiliation
Statistics
Citations: 39
Authors: 76
Affiliations: 12
Identifiers
Doi:
10.1016/S2352-3018(20)30301-5
ISSN:
23523018
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Participants Gender
Male