Impact of HCV Testing and Treatment on HCV Transmission Among Men Who Have Sex With Men and Who Inject Drugs in San Francisco: A Modelling Analysis

Adelina Artenie*, Jack Stone, Shelley N. Facente, Hannah Fraser, Jennifer Hecht, Perry Rhodes III, Willi McFarland, Erin Wilson, Matt Hickman, Peter T Vickerman, Meghan D Morris

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
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Abstract

BackgroundMen who have sex with men who ever injected drugs (ever MSM-IDU) carry a high hepatitis C virus (HCV) burden. We estimated whether current HCV testing and treatment in San Francisco can achieve the 2030 World Health Organization (WHO) HCV elimination target on HCV incidence among ever MSM-IDU.
MethodsA dynamic HCV/HIV transmission model among MSM was calibrated to San Francisco data, including HCV antibody (15.5%, 2011) and HIV prevalence (32.8%, 2017) among ever MSM-IDU. MSM had high HCV testing (79%–86% ever tested, 2011–2019) and diagnosed MSM had high HCV treatment (65% ever treated, 2018). Following coronavirus disease 2019 (COVID-19)–related lockdowns, HCV testing and treatment decreased by 59%.
ResultsAmong all MSM, 43% of incident HCV infections in 2022 were IDU-related. Among ever MSM-IDU in 2015, HCV incidence was 1.2/100 person-years (95% credibility interval [CrI], 0.8–1.6). Assuming COVID-19–related declines in HCV testing/treatment persist until 2030, HCV incidence among ever MSM-IDU will decrease by 84.9% (95% CrI, 72.3%–90.8%) over 2015–2030. This decline is largely attributed to HCV testing and treatment (75.8%; 95% CrI, 66.7%–89.5%). Slightly greater decreases in HCV incidence (94%–95%) are projected if COVID-19 disruptions recover by 2025 or 2022.
ConclusionsWe estimate that HCV incidence will decline by >80% over 2015–2030 among ever MSM-IDU in San Francisco, achieving the WHO target.
Original languageEnglish
Article numberjiad169
Pages (from-to)662-673
Number of pages12
JournalThe Journal of infectious diseases
Volume228
Issue number6
Early online date24 Jun 2023
DOIs
Publication statusPublished - 15 Sept 2023

Bibliographical note

Funding Information:
Potential conflicts of interest. P. V. received investigator sponsored research funding from Gilead Sciences for research not related to this study. M. M. received investigator sponsored research funding from Gilead Sciences for research not related to this study. S. N. F. acknowledges consulting support from Gilead Sciences and from End Hep C SF; neither are related to this study. All other authors report no potential conflicts.

Funding Information:
Financial support. This work was supported by the Canadian Institute of Health Research, Fonds de Recherche du Québec-Santé, and Canadian Network on Hepatitis C (postdoctoral fellowships to A. A.); the National Institute of Health Research Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol (to H. F. and P. V.); and the National Institute for Drug Abuse (grant numbers R01DA033679 and R21DA047902 to H. F. and P. V., and 1R21DA046809 to S. F., H. F., P. V., and M. M.).

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

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