Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions. Hepatology
Salazar-Vizcaya et al. predicted the effect of behavioral and treatment interventions on hepatitis C Virus (HCV) incidence and prevalence among HIV-infected men who have sex with men (MSM) up to 2030 using a HCV transmission model parameterized with data from the Swiss HIV Cohort Study. In their model the prevention of high-risk behavior alone resulted in a considerably reduced HCV transmission. Contrary, if high-risk behavior continued and the treatment practice did not change, HCV incidence converged to 10.7/100 person-years. Stabilization of high-risk behavior combined with increased treatment uptake and the use of direct-acting antivirals reduced incidence by 77% (from 2.2 in 2015 to 0.5/100 person-years) and prevalence by 81% (from 4.8% in 2015 to 0.9%) over the next 15 years.
In conclusion, reducing high-risk behavior associated with HCV transmission would be the most effective intervention for controlling the HCV epidemic, even if this was not accompanied by an increase in treatment uptake or efficacy.