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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination

Authors: Victor Virlogeux, Fabien Zoulim, Pascal Pugliese, Isabelle Poizot-Martin, Marc-Antoine Valantin, Lise Cuzin, Jacques Reynes, Eric Billaud, Thomas Huleux, Firouze Bani-Sadr, David Rey, Anne Frésard, Christine Jacomet, Claudine Duvivier, Antoine Cheret, Laurent Hustache-Mathieu, Bruno Hoen, André Cabié, Laurent Cotte, the Dat’AIDS Study Group

Published in: BMC Medicine | Issue 1/2017

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Abstract

Background

HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model.

Methods

The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups were considered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals, intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence data observed in the cohort between 2012 and 2015.

Results

On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosed patients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatment coverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalence among HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCV prevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalence in HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70% would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients would account for 34% of HCV infections in 2026.

Conclusions

Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most risk groups, including LR MSM. Elimination in HR MSM will require increased TC.
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Metadata
Title
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination
Authors
Victor Virlogeux
Fabien Zoulim
Pascal Pugliese
Isabelle Poizot-Martin
Marc-Antoine Valantin
Lise Cuzin
Jacques Reynes
Eric Billaud
Thomas Huleux
Firouze Bani-Sadr
David Rey
Anne Frésard
Christine Jacomet
Claudine Duvivier
Antoine Cheret
Laurent Hustache-Mathieu
Bruno Hoen
André Cabié
Laurent Cotte
the Dat’AIDS Study Group
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0979-1

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