Engaging with HCV reinfection to advance microelimination

Abstract

Increased access to direct-acting antiviral therapy for the treatment of hepatitis C virus (HCV) has transformed not only individual outcomes for treatment, but also the ambition of health-care systems to eliminate the virus as a public health threat. Services for people living with HIV are well suited to microelimination approaches, 1 The Lancet HIVMicroelimination could be a big deal for HCV and HIV services. Lancet HIV. 2018; 5: e605 Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar , 2 Lazarus JV Picchio CA Byrne C et al. A global systematic review of hepatitis C elimination efforts through micro-elimination. Semin Liver Dis. 2022; (published online Feb 21.)https://doi.org/10.1055/a-1777-6112 PubMed Google Scholar , 3 Martinello M Yee J Bartlett SR et al. Moving towards hepatitis C microelimination among people living with human immunodeficiency virus in Australia: the CEASE Study. Clin Infect Dis. 2020; 71: 1502-1510 Crossref PubMed Scopus (26) Google Scholar with specific elimination targets (eg, those set out in 2018 by the British HIV Association) for well defined subpopulations. In the absence of an effective HCV vaccine for the foreseeable future, individuals with ongoing risk of HCV exposure remain susceptible to reinfection following cure. Reinfection poses not only a challenge to an individual's health but could also risk undermining greater elimination (and microelimination) efforts. Risk of hepatitis C reinfection following successful therapy among people living with HIV: a global systematic review, meta-analysis, and meta-regressionRisk of HCV reinfection following treatment in people living with HIV was highest among MSM and those with recent HCV infection. Continued scale-up of HCV treatment and ongoing HCV screening and treatment of infection in this patient population should reduce viraemic burden and risk of reinfection. Full-Text PDF