The hepatitis C virus epidemics in key populations (including people who inject
drugs, prisoners and MSM): the use of direct-acting antivirals as treatment for
prevention
#MMPMID26248124
Martin NK
; Vickerman P
; Dore GJ
; Hickman M
Curr Opin HIV AIDS
2015[Sep]; 10
(5
): 374-80
PMID26248124
show ga
PURPOSE OF REVIEW: The burden of hepatitis C virus (HCV) is high among people who
inject drugs (PWID) and prisoners, and increasing among HIV-infected MSM, who are
key populations for HCV transmission in high-income countries and may also play a
role in many in low- and middle-income countries. There is an increasing interest
in the use of HCV antiviral treatment for prevention in these populations. RECENT
FINDINGS: Numerous theoretical modelling studies have explored the potential
impact of HCV treatment for prevention among PWID in a range of global settings,
generally finding that modest and achievable levels of HCV treatment, especially
with interferon-free direct-acting antiviral therapy (IFN-free DAAs), could
substantially reduce HCV chronic prevalence among PWID within the next 10-20
years. In addition, modelling studies have shown HCV testing and treatment in
prison (including prevention benefits) could be cost-effective if continuity of
care is ensured, or HCV treatments are shortened with DAAs. Modelling work among
HIV-infected MSM has shown that further HCV treatment scale-up is likely required
despite high treatment rates in this population. However, no empirical studies
have explored whether HCV treatment can reduce HCV prevalence and prevent onwards
transmission among those at risk of transmission. SUMMARY: HCV treatment for key
populations such as PWID, prisoners and MSM could become an important HCV
prevention intervention, especially in the IFN-free DAA era. However, there is an
urgent need to test these hypotheses through empirical studies.
|*Drug Users
[MESH]
|*Homosexuality, Male
[MESH]
|*Prisoners
[MESH]
|Antiviral Agents/*administration & dosage
[MESH]
|Chemoprevention/*methods
[MESH]
|Disease Transmission, Infectious/prevention & control
[MESH]
|Hepatitis C/*epidemiology/*prevention & control
[MESH]
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