Sustained effect on hepatitis C elimination among men who have sex with men in the Swiss HIV Cohort Study: A systematic re-screening for hepatitis C RNA two years following a nation-wide elimination program. Clinical Infectious Diseases
Kuseijo et al. aimed to explore the long-term effect of the Swiss HCVree Trial. This trial was conducted in 2015–2017 with the goal of implementing a population-based systematic hepatitis C virus (HCV) micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) enrolled in the Swiss HIV Cohort Study (SHCS). The trial led to a 91% and 77% decline of HCV prevalence and incidence, respectively. The crucial question after the Swiss HCVree Trial was, whether this short-term effort was enough for achieving a further decrease of HCV prevalence and incidence, or at least for maintaining the post-intervention level.
All MSM enrolled in the SHCS were screened for HCV RNA using stored plasma samples obtained in 2019, termed “Swiss HCVree Post” screen. The incidence of HCV infection over time was assessed using additional information on HCV testing routinely collected in the SHCS. Characteristics of participants with replicating HCV infection were analyzed.
The point-prevalence of “Swiss HCVree Post” (N=4641) was 0.6%, reflecting a decline of 48% compared to the end of the Swiss HCVree Trial where the prevalence was 1.2%. Further, the incidence of HCV among MSM in the SHCS declined from 0.31/100 person-years (py) (95% confidence interval [CI] [.17, .55]) in 2017 to 0.19/100 py (95% CI [.09, .39]) in 2019.
In conclusion, the systematic screening and testing in the Swiss HCVree Trial followed by continuous surveillance and direct acting agent treatment in the SHCS resulted in a sustained marked reduction in HCV incidence and prevalence. This indicates that the Swiss HCVree Trial was successful in curbing the HCV epidemic among MSM living with HIV in Switzerland.