@article{808d47c67f3a4cc881e58feac59497f6,
title = "HCV micro-elimination in individuals with HIV in the Netherlands 4 years after universal access to direct-acting antivirals: a retrospective cohort study",
abstract = "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.",
author = "Colette Smit and Anders Boyd and Rijnders, \{Bart J. A.\} and \{van de Laar\}, \{Thijs J. W.\} and Leyten, \{Eliane M.\} and Bierman, \{Wouter F.\} and Newsum, \{Astrid M.\} and Janke Schinkel and Maria Prins and \{van der Valk\}, Marc and Peter Reiss and \{ATHENA observational cohort\} and \{van der Valk\}, M. and Geerlings, \{S. E.\} and A. Goorhuis and Hovius, \{J. W.\} and Nellen, \{F. J. B.\} and \{van der Poll\}, T. and Prins, \{J. M.\} and \{van Vugt\}, M. and Wiersinga, \{W. J.\} and Wit, \{F. W. M. N.\} and S. Jurriaans and Back, \{N. K. T.\} and Zaaijer, \{H. L.\} and B. Berkhout and Cornelissen, \{M. T. E.\} and Schinkel, \{C. J.\} and Wolthers, \{K. C.\} and Sigaloff, \{K. C. E.\} and Ang, \{C. W.\} and A. Reuwer and J. Nellen and \{van Nood\}, E. and R. Renckens and M. Kok and J. Hoogerwerf and O. Richel and Stelma, \{F. F.\} and N. Langebeek and Lauw, \{F. N.\} and \{van Wijk\}, M. and M. Bakker and Y. Stienstra and P. Reiss and Bezemer, \{D. O.\} and \{van Sighem\}, \{A. I.\} and C. Smit and \{van de Sande\}, L. and M. Groters and M. Schoorl and Kees Brinkman and Claassen, \{Mark A.A.\} and \{den Hollander\}, Jan and Anne Boerekamps and Arends, \{Joop E.\} and \{Op de Coul\}, \{Eline L.M.\} and B. Lempkes and \{van Duinen\}, M. and \{van Eden\}, J. and A. Hazenberg and \{van Hes\}, \{A. M.H.\} and Pijnappel, \{F. J.J.\} and Smalhout, \{S. Y.\} and Weijsenfeld, \{A. M.\} and Peters, \{E. J.G.\} and \{van Agtmael\}, \{M. A.\} and Autar, \{R. S.\} and M. Bomers and M. Heitmuller and Laan, \{L. M.\} and \{van Houdt\}, R. and M. Jonges and \{van den Berge\}, M. and A. Stegeman and S. Baas and \{Hage de Looff\}, L. and A. Buiting and J. Veenemans and B. Wintermans and Pronk, \{M. J.H.\} and Ammerlaan, \{H. S.M.\} and \{van den Bersselaar\}, \{D. N.J.\} and \{de Munnik\}, \{E. S.\} and B. Deiman and Jansz, \{A. R.\} and V. Scharnhorst and J. Tjhie and Wegdam, \{M. C.A.\} and \{van Eeden\}, A. and W. Brokking and Elsenburg, \{L. J.M.\} and H. Nobel and \{van Kasteren\}, \{M. E.E.\} and Berrevoets, \{M. A.H.\} and Brouwer, \{A. E.\} and A. Adams and \{van Erve\}, R. and \{de Kruijf-van de Wiel\}, \{B. A.F.M.\} and S. Keelan-Phaf and \{van de Ven\}, B. and Buiting, \{A. G.M.\} and Murck, \{J. L.\} and \{de Vries-Sluijs\}, \{T. E.M.S.\} and Bax, \{H. I.\} and \{van Gorp\}, \{E. C.M.\} and \{de Jong-Peltenburg\}, \{N. C.\} and \{de Mendon{\c c}a Melo\}, M. and Nouwen, \{J. L.\} and C. Rokx and Schurink, \{C. A.M.\} and L. Slobbe and A. Verbon and N. Bassant and \{van Beek\}, \{J. E.A.\} and M. Vriesde and \{van Zonneveld\}, \{L. M.\} and \{de Groot\}, J. and Boucher, \{C. A.B.\} and Koopmans, \{M. P.G.\} and \{van Kampen\}, \{J. J.A.\} and J. Branger and Douma, \{R. A.\} and Cents-Bosma, \{A. S.\} and \{Duijf-van de Ven\}, \{C. J.H.M.\} and Schippers, \{E. F.\} and \{van Nieuwkoop\}, C. and \{van IJperen\}, \{J. M.\} and J. Geilings and \{van Burgel\}, \{N. D.\} and \{van der Hut\}, G. and Gelinck, \{L. B.S.\} and F. Mollema and S. Davids-Veldhuis and C. Tearno and Wildenbeest, \{G. S.\} and E. Heikens and Groeneveld, \{P. H.P.\} and Bouwhuis, \{J. W.\} and Lammers, \{A. J.J.\} and S. Kraan and \{van Hulzen\}, \{A. G.W.\} and Kruiper, \{M. S.M.\} and \{van der Bliek\}, \{G. L.\} and Bor, \{P. C.J.\} and Debast, \{S. B.\} and Wagenvoort, \{G. H.J.\} and Kroon, \{F. P.\} and \{de Boer\}, \{M. G.J.\} and H. Jolink and Lambregts, \{M. M.C.\} and Roukens, \{A. H.E.\} and H. Scheper and W. Dorama and \{van Holten\}, N. and Claas, \{E. C.J.\} and E. Wessels and \{den Hollander\}, \{J. G.\} and Brouwer, \{C. J.\} and Smit, \{J. V.\} and D. Struik-Kalkman and \{van Niekerk\}, T. and \{El Moussaoui\}, R. and K. Pogany and O. Pontesilli and Lowe, \{S. H.\} and \{Oude Lashof\}, \{A. M.L.\} and D. Posthouwer and \{van Wolfswinkel\}, \{M. E.\} and Ackens, \{R. P.\} and K. Burgers and J. Schippers and B. Weijenberg-Maes and \{van Loo\}, \{I. H.M.\} and Havenith, \{T. R.A.\} and \{van Vonderen\}, \{M. G.A.\} and Kampschreur, \{L. M.\} and S. Faber and R. Steeman-Bouma and \{Al Moujahid\}, A. and Kootstra, \{G. J.\} and Delsing, \{C. E.\} and \{van der Burg-van de Plas\}, M. and L. Scheiberlich and W. Kortmann and \{van Twillert\}, G. and D. Ruiter-Pronk and \{van Truijen-Oud\}, \{F. A.\} and \{Cohen Stuart\}, \{J. W.T.\} and Jansen, \{E. R.\} and M. Hoogewerf and W. Rozemeijer and \{van der Reijden\}, \{W. A.\} and Sinnige, \{J. C.\} and K. Brinkman and \{van den Berk\}, \{G. E.L.\} and Blok, \{W. L.\} and Lettinga, \{K. D.\} and \{de Regt\}, M. and Schouten, \{W. E.M.\} and Stalenhoef, \{J. E.\} and J. Veenstra and Vrouenraets, \{S. M.E.\} and H. Blaauw and Geerders, \{G. F.\} and Kleene, \{M. J.\} and M. Knapen and \{van der Mech{\'e}\}, \{I. B.\} and E. Mulder-Seeleman and Toonen, \{A. J.M.\} and S. Wijnands and E. Wttewaal and D. Kwa and \{van Crevel\}, R. and Dofferhoff, \{A. S.M.\} and \{ter Hofstede\}, \{H. J.M.\} and M. Keuter and M. Albers and Grintjes-Huisman, \{K. J.T.\} and \{de Haan\}, M. and M. Marneef and R. Strik-Albers and J. Rahamat-Langendoen and D. Burger and Gisolf, \{E. H.\} and Hassing, \{R. J.\} and M. Claassen and \{ter Beest\}, G. and \{van Bentum\}, \{P. H.M.\} and R. Tiemessen and Swanink, \{C. M.A.\} and \{van Lelyveld\}, \{S. F.L.\} and R. Soetekouw and \{van der Prijt\}, \{L. M.M.\} and \{van der Swaluw\}, J. and N. Bermon and R. Jansen and Herpers, \{B. L.\} and D. Veenendaal and Verhagen, \{D. W.M.\} and \{van Broekhuizen\}, \{M. C.\} and J. Kleinnijenhuis and E. Kloeze and A. Middel and Postma, \{D. F.\} and A. Boonstra and \{de Groot-de Jonge\}, H. and \{van der Meulen\}, \{P. A.\} and \{de Weerd\}, \{D. A.\} and Niesters, \{H. G.M.\} and \{van Leer-Buter\}, \{C. C.\} and M. Knoester and Hoepelman, \{A. I.M.\} and Arends, \{J. E.\} and Barth, \{R. E.\} and Bruns, \{A. H.W.\} and Ellerbroek, \{P. M.\} and T. Mudrikova and Oosterheert, \{J. J.\} and Schadd, \{E. M.\} and \{van Welzen\}, \{B. J.\} and K. Aarsman and \{Griffioen-van Santen\}, \{B. M.G.\} and \{de Kroon\}, I. and \{van Berkel\}, M. and \{van Rooijen\}, \{C. S.A.M.\} and R. Schuurman and F. Verduyn-Lunel and Wensing, \{A. M.J.\} and S. Zaheri and M. Hillebregt and \{de Jong\}, A. and T. Woudstra and D. Bergsma and R. Meijering and T. Rutkens and \{van der Vliet\}, S. and \{de Groot\}, L. and \{van den Akker\}, M. and Y. Bakker and \{El Berkaoui\}, A. and M. Bezemer and N. Br{\'e}tin and E. Djoechro and E. Kruijne and Lelivelt, \{K. J.\} and C. Lodewijk and E. Lucas and L. Munjishvili and F. Paling and B. Peeck and C. Ree and R. Regtop and Y. Ruijs and P. Schn{\"o}rr and A. Scheigrond and E. Tuijn and L. Veenenberg and Visser, \{K. M.\} and Witte, \{E. C.\}",
note = "Funding Information: BJAR reports grants from MSD and Gilead, outside the submitted work and is a member of advisory boards for MSD, Gilead, Pfizer, ViiV Healthcare, Jansen-Cilag, and Abbvie. WFB reports reimbursement of costs inclusion patient in industry-sponsored RCT from GSK and non-financial support from Janssen, all outside the submitted work. KB is an advisory board member for ViiV Healthcare, Gilead, MSD, and Janssen; and reports grants form ViiV Healthcare and Gilead. JS reports grants from Gilead Sciences, outside the submitted work. MP reports grants, personal fees, speakers fees and independent scientific support to their institution from Gilead Sciences, Roche, MSD, and Abbvie, all outside the submitted work. JEA reports fees paid to their institution from Gilead, Janssen-Cilag, Abbvie, Bristol-Myers Squibb, and MSD for advisory membership, all outside the submitted work. MvdV reports grants and personal fees from Abbvie, Gilead, Johnson \& Johnson, MSD, and ViiV Healthcare, all outside the submitted work. PR reports grants from Gilead, ViiV Healthcare, and Merck \& Co; and honoraria and is an advisory board member for Gilead Sciences, ViiV Healthcare, Merck \& Co, and Teva Pharmaceutical Industries, all outside the submitted work. All other authors report no competing interests. Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = feb,
doi = "10.1016/S2352-3018(20)30301-5",
language = "English",
volume = "8",
pages = "e96--e105",
journal = "Lancet HIV",
issn = "2352-3018",
publisher = "Elsevier Ltd",
number = "2",
}
SDG 3 Good Health and Well-being
SDG 5 Gender Equality