Modelling the impact of deferring HCV treatment on liver-related complications in HIV coinfected men who have sex with men. Journal of Hepatology
Zahnd et al. aimed to estimate the long term impact of deferring hepatitis C virus (HCV) treatment for men who have sex with men who are coinfected with HIV for liver disease progression. The percentage of simulated individuals who died of liver-related complications was 2% if treatment was initiated in F0 or in F1. It rose to 3% if treatment was deferred until F2, 7% if deferred until F3, and 22% if deferred until F4. The median time individuals spent with replicating HCV increased from 5 years if treatment was initiated in F2 to almost 15 years if it was deferred until F4. The cost calculations suggest that early treatment might be cost-effective since the increase in treatment cost is balanced by the savings in health care costs. In conclusion, the study-findings support arguments that HCV therapy should be accessible to everyone at an early stage. To make this affordable for health insurances and governments, the costs for new direct acting antivirals need to be lowered substantially.