Australia is on path to eliminate HCV before 2030 for men who have sex with men

An Australian Study looked at the incidence of the Hepatitis C Virus (HCV) among men who have sex with other men (GBM) between 2015 and 2019. The study found that the incidence of HCV for GBM living with HIV declined after the introduction of direct-acting antiviral treatment (DAA) in 2016. Although the same could not be said for HIV-negative GBM overall, the incidence did also decline for GBM using HIV preexposure prophylaxis (PrEP). You can read the abstract of the study below.

The Incidence of Hepatitis C Among Gay, Bisexual, and Other Men Who Have Sex With Men in Australia, 2009–2019 Brendan L HarneyRachel Sacks-DavisDaniela K van SantenMichael TraegerAnna L WilkinsonJason AsselinCarol El-HayekChristopher K FairleyNorman RothMark Bloch Clinical Infectious Diseases, ciab720, https://doi.org/10.1093/cid/ciab720

Published:   25 October 2021

Background Hepatitis C virus (HCV) infection has been reported among gay, bisexual, and other men who have sex with men (GBM) globally including GBM with human immunodeficiency virus (HIV) and HIV-negative GBM, particularly those using HIV preexposure prophylaxis (PrEP). In Australia, HCV direct-acting antiviral treatment (DAA) was government-funded from 2016. Large implementation studies of PrEP also began in 2016. We examined HCV incidence among GBM to assess whether HCV incidence has changed since 2015.

Methods Data were drawn from the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance. We included GBM who tested HCV antibody negative at their first test and had ≥1 subsequent test. Generalized linear modeling (Poisson distribution) was used to examine HCV incidence from 2009 to 2019 stratified by HIV status, and among HIV-negative GBM prescribed PrEP from 2016 to 2019.

Results Among 6744 GBM with HIV, HCV incidence was 1.03 per 100 person- years (PY). Incidence declined by 78% in 2019 compared to 2015 (incidence rate ratio [IRR], 0.22 [95% confidence interval {CI}: .09–.55]). Among 20 590 HIV-negative GBM, HCV incidence was 0.20/100 PY, with no significant change over time. Among 11 661 HIV-negative GBM prescribed PrEP, HCV incidence was 0.29/100 PY. Compared to 2016, incidence among GBM prescribed PrEP declined by 80% in 2019 (IRR, 0.20 [95% CI: .06–.64]).

Conclusions HCV incidence among GBM living with HIV declined following DAA availability. There was no observed change in HCV incidence among HIV-negative GBM overall. Among GBM prescribed PrEP, incidence declined since the early years of PrEP implementation in Australia. Australia is on track to eliminate HCV among GBM before global 2030 targets.


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