New cases of hepatitis C fell among gay and bisexual men living with HIV in France – .

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New cases of hepatitis C fell among gay and bisexual men living with HIV in France – .


The rate of new hepatitis C infections halved among HIV-positive gay and bisexual men in France between 2014 and 2017 following the introduction of direct-acting antivirals, reported a French cohort study.
However, Dr Mathieu Castry and colleagues say further harm reduction measures will be needed to reduce the transmission of hepatitis C and achieve micro-elimination of the virus in gay and bisexual men living with HIV in France. .

Transmission of hepatitis C began to increase among HIV-positive gay and bisexual men in Europe and North America after 2000. A previous French study found that the prevalence of hepatitis C had doubled in this population between 2012 and 2018. The increase in transmission of hepatitis C in this population is due to unprotected anal intercourse, fisting, group sex, and sexualized injection drug use, which may involve sharing equipment. ‘injection.

Glossary

antiviral

Drug that acts against one or more viruses.

Acute infection

The first few weeks of infection, until the body has created antibodies against the infection. During an acute HIV infection, HIV is highly infectious because the virus multiplies at a very rapid rate. Symptoms of an acute HIV infection may include fever, rash, chills, headache, fatigue, nausea, diarrhea, sore throat, night sweats, loss of appetite, mouth ulcers, swollen lymph nodes, muscle and joint pain – all symptoms of an acute infection. inflammation (immune reaction).

person-years

In one study, “100 person-years of follow-up” could mean that information was collected on 100 people for one year, or on 50 people for two years each, or on ten people over ten years. In practice, the duration of follow-up for each person is likely to be different.

statistical significance

Statistical tests are used to judge whether the results of a study could be due to chance and would not be confirmed if the study were repeated. While the result is probably not due to chance, the results are “statistically significant”.

value p

The result of a statistical test that tells us if the results of a study are likely due to chance and would not be confirmed if the study were repeated. All p values ​​are between 0 and 1; the most reliable studies have p-values ​​very close to 0. A p-value of 0.001 means that there is a probability of 1 in 1000 that the results are due to chance and do not reflect a real difference. A p-value of 0.05 means that there is a probability of 1 in 20 that the results are due to chance. When a p-value is equal to or less than 0.05, the result is considered “statistically significant”. Confidence intervals give similar information to p values ​​but are easier to interpret.

Several modeling studies have predicted that the incidence of hepatitis C could be significantly reduced in gay and bisexual men through high levels of treatment and cure for chronic infection, as well as treatment for acute infection. .

To assess the possible impact of direct-acting antiviral therapy on the incidence of hepatitis C in France, researchers examined the incidence of hepatitis C in the French hospital HIV database, a representative cohort at the national level of people living with HIV receiving care in 175 hospitals in France between 2014 and 2017.

Treatment for hepatitis C using second generation direct-acting antivirals was available without restriction to people living with HIV throughout the study period.

Researchers identified 14,273 gay or bisexual men in the cohort who attended a clinic between 2014 and 2017, had a negative hepatitis C antibody test in the two years prior to inclusion in the analysis, and a subsequent hepatitis C antibody test between 2014 and 2017. From there. cohort, they calculated the incidence of hepatitis C between 2014 and 2017, assuming that all selected participants were tested every six months according to French guidelines.

People included in the analysis had a median age of 44 years, 83% were taking antiretroviral therapy at the start of the follow-up period and 99% at the end of the follow-up, and 71% had an undetectable viral load (

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