Hepatitis C Virus Micro-elimination Among People With HIV in San Diego: Are We on Track?

Jaskaran S Cheema; William C Mathews; Adriane Wynn; Laura B Bamford; Francesca J Torriani; Lucas A Hill; Amutha V Rajagopal; Jeffrey Yin; Sonia Jain; Richard S Garfein; Edward R Cachay; Natasha K Martin

doi:10.1093/ofid/ofad153

Hepatitis C Virus Micro-elimination Among People With HIV in San Diego: Are We on Track?

Jaskaran S Cheema
, William C Mathews
, Adriane Wynn
, Laura B Bamford
, Francesca J Torriani
, Lucas A Hill
, Amutha V Rajagopal
, Jeffrey Yin
, Sonia Jain
, Richard S Garfein
, Edward R Cachay^*
, Natasha K Martin^*

^*Corresponding author for this work

Bristol Medical School (PHS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

4 Citations (Scopus)

Abstract

Background

Rising incidence of hepatitis C virus (HCV) among people with HIV (PWH) in San Diego County (SDC) was reported. In 2018, the University of California San Diego (UCSD) launched a micro-elimination initiative among PWH, and in 2020 SDC launched an initiative to reduce HCV incidence by 80% across 2015–2030. We model the impact of observed treatment scale-up on HCV micro-elimination among PWH in SDC.
Methods

A model of HCV transmission among people who inject drugs (PWID) and men who have sex with men (MSM) was calibrated to SDC. The model was additionally stratified by age, gender, and HIV status. The model was calibrated to HCV viremia prevalence among PWH in 2010, 2018, and 2021 (42.1%, 18.5%, and 8.5%, respectively), and HCV seroprevalence among PWID aged 18–39 years, MSM, and MSM with HIV in 2015. We simulate treatment among PWH, weighted by UCSD Owen Clinic (reaching 26% of HCV-infected PWH) and non-UCSD treatment, calibrated to achieve the observed HCV viremia prevalence. We simulated HCV incidence with observed and further treatment scale-up (+/− risk reductions) among PWH.
Results

Observed treatment scale-up from 2018 to 2021 will reduce HCV incidence among PWH in SDC from a mean of 429 infections/year in 2015 to 159 infections/year in 2030. County-wide scale-up to the maximum treatment rate achieved at UCSD Owen Clinic (in 2021) will reduce incidence by 69%, missing the 80% incidence reduction target by 2030 unless accompanied by behavioral risk reductions.
Conclusions

As SDC progresses toward HCV micro-elimination among PWH, a comprehensive treatment and risk reduction approach is necessary to reach 2030 targets.

Original language	English
Article number	ofad153
Journal	Open Forum Infectious Diseases
Volume	10
Issue number	4
Early online date	22 Mar 2023
DOIs	https://doi.org/10.1093/ofid/ofad153
Publication status	Published - 4 Apr 2023

Bibliographical note

Funding Information:
Potential conflicts of interest. N.M. has received unrestricted research grants from Gilead and Merck. E.R.C. has received unrestricted research grants from Gilead and Merck. He also participated in an advisory board for Theratechnologies for an unrelated topic.

Funding Information:
This study was funded by the NoCo Grant funded by Gilead Sciences (IN-US-334-4481). The funders played no role in the design or interpretation of this study. N.M., E.C., and S.J. were additionally funded by the San Diego Center for AIDS Research (SD CFAR), an NIH-funded program (P30 AI036214), which the following NIH Institutes and Centers support: NIAID, NCI, NHLBI, NIA, NICHD, NIDA, NIDCR, NIDDK, NIGMS, NIMH, NIMHD, FIC, and OAR. Data from the STAHR study were obtained with support from the National Institute of Drug Abuse (R01 DA031074).

Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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@article{45a4f808b2434faeb68b85cb2cf1d99e,

title = "Hepatitis C Virus Micro-elimination Among People With HIV in San Diego: Are We on Track?",

abstract = "Background Rising incidence of hepatitis C virus (HCV) among people with HIV (PWH) in San Diego County (SDC) was reported. In 2018, the University of California San Diego (UCSD) launched a micro-elimination initiative among PWH, and in 2020 SDC launched an initiative to reduce HCV incidence by 80\% across 2015–2030. We model the impact of observed treatment scale-up on HCV micro-elimination among PWH in SDC. Methods A model of HCV transmission among people who inject drugs (PWID) and men who have sex with men (MSM) was calibrated to SDC. The model was additionally stratified by age, gender, and HIV status. The model was calibrated to HCV viremia prevalence among PWH in 2010, 2018, and 2021 (42.1\%, 18.5\%, and 8.5\%, respectively), and HCV seroprevalence among PWID aged 18–39 years, MSM, and MSM with HIV in 2015. We simulate treatment among PWH, weighted by UCSD Owen Clinic (reaching 26\% of HCV-infected PWH) and non-UCSD treatment, calibrated to achieve the observed HCV viremia prevalence. We simulated HCV incidence with observed and further treatment scale-up (+/− risk reductions) among PWH. Results Observed treatment scale-up from 2018 to 2021 will reduce HCV incidence among PWH in SDC from a mean of 429 infections/year in 2015 to 159 infections/year in 2030. County-wide scale-up to the maximum treatment rate achieved at UCSD Owen Clinic (in 2021) will reduce incidence by 69\%, missing the 80\% incidence reduction target by 2030 unless accompanied by behavioral risk reductions. Conclusions As SDC progresses toward HCV micro-elimination among PWH, a comprehensive treatment and risk reduction approach is necessary to reach 2030 targets.",

author = "Cheema, \{Jaskaran S\} and Mathews, \{William C\} and Adriane Wynn and Bamford, \{Laura B\} and Torriani, \{Francesca J\} and Hill, \{Lucas A\} and Rajagopal, \{Amutha V\} and Jeffrey Yin and Sonia Jain and Garfein, \{Richard S\} and Cachay, \{Edward R\} and Martin, \{Natasha K\}",

note = "Funding Information: Potential conflicts of interest. N.M. has received unrestricted research grants from Gilead and Merck. E.R.C. has received unrestricted research grants from Gilead and Merck. He also participated in an advisory board for Theratechnologies for an unrelated topic. Funding Information: This study was funded by the NoCo Grant funded by Gilead Sciences (IN-US-334-4481). The funders played no role in the design or interpretation of this study. N.M., E.C., and S.J. were additionally funded by the San Diego Center for AIDS Research (SD CFAR), an NIH-funded program (P30 AI036214), which the following NIH Institutes and Centers support: NIAID, NCI, NHLBI, NIA, NICHD, NIDA, NIDCR, NIDDK, NIGMS, NIMH, NIMHD, FIC, and OAR. Data from the STAHR study were obtained with support from the National Institute of Drug Abuse (R01 DA031074). Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.",

year = "2023",

month = apr,

day = "4",

doi = "10.1093/ofid/ofad153",

language = "English",

volume = "10",

journal = "Open Forum Infectious Diseases",

issn = "2328-8957",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - Hepatitis C Virus Micro-elimination Among People With HIV in San Diego

T2 - Are We on Track?

AU - Cheema, Jaskaran S

AU - Mathews, William C

AU - Wynn, Adriane

AU - Bamford, Laura B

AU - Torriani, Francesca J

AU - Hill, Lucas A

AU - Rajagopal, Amutha V

AU - Yin, Jeffrey

AU - Jain, Sonia

AU - Garfein, Richard S

AU - Cachay, Edward R

AU - Martin, Natasha K

N1 - Funding Information: Potential conflicts of interest. N.M. has received unrestricted research grants from Gilead and Merck. E.R.C. has received unrestricted research grants from Gilead and Merck. He also participated in an advisory board for Theratechnologies for an unrelated topic. Funding Information: This study was funded by the NoCo Grant funded by Gilead Sciences (IN-US-334-4481). The funders played no role in the design or interpretation of this study. N.M., E.C., and S.J. were additionally funded by the San Diego Center for AIDS Research (SD CFAR), an NIH-funded program (P30 AI036214), which the following NIH Institutes and Centers support: NIAID, NCI, NHLBI, NIA, NICHD, NIDA, NIDCR, NIDDK, NIGMS, NIMH, NIMHD, FIC, and OAR. Data from the STAHR study were obtained with support from the National Institute of Drug Abuse (R01 DA031074). Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

PY - 2023/4/4

Y1 - 2023/4/4

N2 - Background Rising incidence of hepatitis C virus (HCV) among people with HIV (PWH) in San Diego County (SDC) was reported. In 2018, the University of California San Diego (UCSD) launched a micro-elimination initiative among PWH, and in 2020 SDC launched an initiative to reduce HCV incidence by 80% across 2015–2030. We model the impact of observed treatment scale-up on HCV micro-elimination among PWH in SDC. Methods A model of HCV transmission among people who inject drugs (PWID) and men who have sex with men (MSM) was calibrated to SDC. The model was additionally stratified by age, gender, and HIV status. The model was calibrated to HCV viremia prevalence among PWH in 2010, 2018, and 2021 (42.1%, 18.5%, and 8.5%, respectively), and HCV seroprevalence among PWID aged 18–39 years, MSM, and MSM with HIV in 2015. We simulate treatment among PWH, weighted by UCSD Owen Clinic (reaching 26% of HCV-infected PWH) and non-UCSD treatment, calibrated to achieve the observed HCV viremia prevalence. We simulated HCV incidence with observed and further treatment scale-up (+/− risk reductions) among PWH. Results Observed treatment scale-up from 2018 to 2021 will reduce HCV incidence among PWH in SDC from a mean of 429 infections/year in 2015 to 159 infections/year in 2030. County-wide scale-up to the maximum treatment rate achieved at UCSD Owen Clinic (in 2021) will reduce incidence by 69%, missing the 80% incidence reduction target by 2030 unless accompanied by behavioral risk reductions. Conclusions As SDC progresses toward HCV micro-elimination among PWH, a comprehensive treatment and risk reduction approach is necessary to reach 2030 targets.

AB - Background Rising incidence of hepatitis C virus (HCV) among people with HIV (PWH) in San Diego County (SDC) was reported. In 2018, the University of California San Diego (UCSD) launched a micro-elimination initiative among PWH, and in 2020 SDC launched an initiative to reduce HCV incidence by 80% across 2015–2030. We model the impact of observed treatment scale-up on HCV micro-elimination among PWH in SDC. Methods A model of HCV transmission among people who inject drugs (PWID) and men who have sex with men (MSM) was calibrated to SDC. The model was additionally stratified by age, gender, and HIV status. The model was calibrated to HCV viremia prevalence among PWH in 2010, 2018, and 2021 (42.1%, 18.5%, and 8.5%, respectively), and HCV seroprevalence among PWID aged 18–39 years, MSM, and MSM with HIV in 2015. We simulate treatment among PWH, weighted by UCSD Owen Clinic (reaching 26% of HCV-infected PWH) and non-UCSD treatment, calibrated to achieve the observed HCV viremia prevalence. We simulated HCV incidence with observed and further treatment scale-up (+/− risk reductions) among PWH. Results Observed treatment scale-up from 2018 to 2021 will reduce HCV incidence among PWH in SDC from a mean of 429 infections/year in 2015 to 159 infections/year in 2030. County-wide scale-up to the maximum treatment rate achieved at UCSD Owen Clinic (in 2021) will reduce incidence by 69%, missing the 80% incidence reduction target by 2030 unless accompanied by behavioral risk reductions. Conclusions As SDC progresses toward HCV micro-elimination among PWH, a comprehensive treatment and risk reduction approach is necessary to reach 2030 targets.

U2 - 10.1093/ofid/ofad153

DO - 10.1093/ofid/ofad153

M3 - Article (Academic Journal)

C2 - 37065984

SN - 2328-8957

VL - 10

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

IS - 4

M1 - ofad153

ER -

Hepatitis C Virus Micro-elimination Among People With HIV in San Diego: Are We on Track?

Abstract

Bibliographical note

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