瑞士艾滋病毒队列研究中男男性行为者中丙型肝炎消除的持续效果：在全国消除计划两年后对丙型肝炎 RNA 进行系统重新筛查。

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.

机构信息

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Institute of Medical Virology, University of Zurich, Zurich, Switzerland.

出版信息

Clin Infect Dis. 2022 Nov 14;75(10):1723-1731. doi: 10.1093/cid/ciac273.

DOI:10.1093/cid/ciac273

PMID:35404384

Abstract

BACKGROUND

The Swiss HCVree Trial (NCT02785666) 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) 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 long-term effect of this HCV micro-elimination program is yet to be explored.

METHODS

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.

RESULTS

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.

CONCLUSIONS

A systematic HCV RNA-based screening among MSM with HIV conducted 2 years after the Swiss HCVree Trial revealed a sustained effect and further decline of the prevalence and incidence of replicating HCV infection. This indicates that the Swiss HCVree Trial was successful in curbing the HCV epidemic among MSM with HIV in Switzerland.

CLINICAL TRIALS REGISTRATION

NCT02785666.

摘要

背景

瑞士 HCVree 试验（NCT02785666）于 2015-2017 年进行，旨在为瑞士艾滋病毒队列研究（SHCS）中感染人类免疫缺陷病毒（HIV）的男男性行为者（MSM）实施基于人群的系统丙型肝炎病毒（HCV）消除计划。该试验导致 HCV 流行率分别下降了 91%和 77%。该 HCV 消除计划的长期效果尚待探讨。

方法

所有参加 SHCS 的 MSM 均使用 2019 年获得的储存血浆样本进行 HCV RNA 筛查，称为“瑞士 HCVree 后”筛查。通过 SHCS 常规收集的有关 HCV 检测的额外信息评估 HCV 感染的发病率。分析具有复制性 HCV 感染的参与者的特征。

结果

“瑞士 HCVree 后”的时点流行率（N=4641）为 0.6%，与瑞士 HCVree 试验结束时的 1.2%相比下降了 48%。此外，SHCS 中 MSM 的 HCV 发病率从 2017 年的 0.31/100 人年（95%置信区间 [CI] [.17，.55]）下降到 2019 年的 0.19/100 人年（95%CI [.09，.39]）。