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28.06.2021 | original article | Ausgabe 13-14/2021 Open Access

Wiener klinische Wochenschrift 13-14/2021

Outcomes of an HCV elimination program targeting the Viennese MSM population

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 13-14/2021
Autoren:
MD Mathias Jachs, MD Teresa Binter, MD David Chromy, MD Horst Schalk, MD Karlheinz Pichler, MD David Bauer, MD Benedikt Simbrunner, MD Lukas Hartl, MD Caroline Schmidbauer, MD Florian Mayer, MD Robert Strassl, MD PhD Mattias Mandorfer, MD Michael Gschwantler, MD Thomas Reiberger
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Summary

Background and aims

Recent reports suggest an increasing incidence of hepatitis C virus (HCV) infections among MSM (men-who-have-sex-with-men). Early treatment with direct-acting antivirals (DAAs) achieves high cure rates and prevents further HCV transmission. We offered barrier-free HCV screening in the Viennese MSM population and immediate access to DAA treatment.

Methods

In collaboration with gay health specialists, we screened for HCV seropositivity in Viennese MSM between 2019 and 2020. Barrier-free HCV-RNA-PCR tests, transient elastography (TE) and immediate access to DAA treatment were offered.

Results

A total of 310 HCV-seropositive patients were identified. Of those, 145 could be contacted and 109 attended their appointment at our clinic. HIV-coinfection was highly prevalent in our cohort (n = 86/145; 78.9%), while pre-exposure prophylaxis (PrEP) was taken by 21.7% (n = 5/23) of non-HIV patients. Sexual risk behavior and (history of) intravenous drug use was reported by 32.1% and 13.8% of patients, respectively. Most MSM had already achieved sustained virological response (SVR) to previous antiviral treatment (n = 72, 66.1%) or experienced spontaneous clearance (n = 10, 9.2%). Advanced fibrosis was only detected in 3/109 (2.8%) patients. 30 MSM tested positive for HCV-RNA and DAA treatment was initiated in 29 patients – all achieved SVR.

Conclusion

A targeted HCV test-and-treat program revealed a high prevalence of HCV seropositivity among Viennese MSM, potentially associated with high-risk sexual behavior and drug use. Early DAA treatment seems warranted in viremic HCV-MSM as SVR was 100%, which in turn prevents further HCV transmission.

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