Impact of directly acting-antivirals and behavior change due to the COVID 19 pandemic on HCV micro-elimination in MSM in Germany
Abstract Introduction Directly-acting antivirals (DAA) are the cornerstone to reach HCV elimination. In men who have sex with men (MSM) with HIV coinfection, recently acquired HCV infection (RAHCV) is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates. Methods The cohort included MSM with RAHCV from 2014 to 2021. The patients’ demographic, clinical, behavioral, and laboratory data were documented, as well as treatment and reinfection outcomes. Results 237 men with RAHCV were included, 216 (91%) were PLWH. Median age was 46 years (IQR: 39–52), median CD4 count was 660/mm3 (IQR: 527–835). The annual incidence of RAHCV remained between 0.28% and 0.43%, but dropped to 0.02% in 2021 during the onset of the COVID-pandemic almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95%-CI: 12.6-18.8), reinfection was associated with use of crystal methamphetamine (p=0.032) and ketamine (p=0.042). 31.3% had multiple reinfections, four reinfections occurred in PrEP users. Conclusions High treatment and cure rates did not lead to HCV elimination. A change in sexual behavior, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As RAHCV is prevalent in HIV-positive and -negative MSM, surveillance is necessary to consolidate elimination goals..
| Medienart: |
|
|---|
Preprint| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
ResearchSquare.com - (2023) vom: 12. Dez. Zur Gesamtaufnahme - year:2023 |
|---|
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ingiliz, Patrick [VerfasserIn] |
|---|
| Links: |
Volltext [kostenfrei] |
|---|
| Themen: |
|---|
| doi: |
10.21203/rs.3.rs-3716276/v1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
XRA041808029 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | XRA041808029 | ||
| 003 | DE-627 | ||
| 005 | 20231214091107.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231209s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.21203/rs.3.rs-3716276/v1 |2 doi | |
| 035 | |a (DE-627)XRA041808029 | ||
| 035 | |a (ResearchSquare)10.21203/rs.3.rs-3716276/v1 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ingiliz, Patrick |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of directly acting-antivirals and behavior change due to the COVID 19 pandemic on HCV micro-elimination in MSM in Germany |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Abstract Introduction Directly-acting antivirals (DAA) are the cornerstone to reach HCV elimination. In men who have sex with men (MSM) with HIV coinfection, recently acquired HCV infection (RAHCV) is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates. Methods The cohort included MSM with RAHCV from 2014 to 2021. The patients’ demographic, clinical, behavioral, and laboratory data were documented, as well as treatment and reinfection outcomes. Results 237 men with RAHCV were included, 216 (91%) were PLWH. Median age was 46 years (IQR: 39–52), median CD4 count was 660/mm3 (IQR: 527–835). The annual incidence of RAHCV remained between 0.28% and 0.43%, but dropped to 0.02% in 2021 during the onset of the COVID-pandemic almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95%-CI: 12.6-18.8), reinfection was associated with use of crystal methamphetamine (p=0.032) and ketamine (p=0.042). 31.3% had multiple reinfections, four reinfections occurred in PrEP users. Conclusions High treatment and cure rates did not lead to HCV elimination. A change in sexual behavior, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As RAHCV is prevalent in HIV-positive and -negative MSM, surveillance is necessary to consolidate elimination goals. | ||
| 650 | 4 | |a Biology |7 (dpeaa)DE-84 | |
| 650 | 4 | |a 570 |7 (dpeaa)DE-84 | |
| 700 | 1 | |a Lutz, Thomas |4 aut | |
| 700 | 1 | |a Schewe, Knud |4 aut | |
| 700 | 1 | |a Baumgarten, Axel |4 aut | |
| 700 | 1 | |a Krznaric, Ivanka |4 aut | |
| 700 | 1 | |a Mauss, Stefan |4 aut | |
| 700 | 1 | |a Christensen, Stefan |4 aut | |
| 700 | 1 | |a Bickel, Markus |4 aut | |
| 700 | 1 | |a Schmidt, Axel Jeremias |4 aut | |
| 700 | 1 | |a Sabranski, Michael |4 aut | |
| 700 | 1 | |a He, Feng |4 aut | |
| 700 | 1 | |a Jain, Sonia |4 aut | |
| 700 | 1 | |a Martin, Nastasha Kaleta |4 aut | |
| 700 | 1 | |a Rockstroh, Jürgen K. |4 aut | |
| 700 | 1 | |a Boesecke, Christoph |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t ResearchSquare.com |g (2023) vom: 12. Dez. |
| 773 | 1 | 8 | |g year:2023 |g day:12 |g month:12 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.21203/rs.3.rs-3716276/v1 |z kostenfrei |3 Volltext |
| 912 | |a GBV_XRA | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 12 |c 12 | ||