New cases of hepatitis C amongst HIV positive men in London have fallen by nearly 70 per cent in recent years. The new analysis of data from three clinics in London found 256 men were diagnosed between 2013-2018. New infections peaked at 17 for every 1000 people studied in 2015 and fell to six by 2018.
The researchers behind the study, from the Imperial College Academic Health Science Centre, believe that regular screening and improved access to new treatments have contributed to greatly reducing the transmission of the infection. They also believe that if this progress can be maintained London will be on track to achieve the targets set out by the British HIV Association to eliminate Hepatitis C in HIV patients by 2021.
The results were presented at The Conference on Retroviruses and Opportunistic Infections, a major HIV conference in Seattle, on Wednesday 6 March.
Professor Graham Cooke, NIHR Professor of Infectious Diseases at Imperial College London and co-author of the paper, said:
“The results from our study should give us great encouragement as we try to eliminate hepatitis C. There is a risk that these gains might be reversed if we can’t retreat patients and we hope that soon this might be possible through NHS services.”
People with HIV who get hepatitis C are more at risk of the disease progressing and they have a higher risk of cirrhosis and liver cancer. Hepatitis C is the leading cause of serious illness and death in people who are HIV/hepatitis C co-infected, attributing to six percent of all deaths.
Despite this, under current guidelines those recently infected with hepatitis C have to wait six months before they can access DAA treatment – a recently-developed treatment which is highly effective in 90% of patients. Also, if a patient is reinfected with hepatitis C they are not eligible for a second course of DAA, potentially increasing the risk of transmission.
The researchers suggest that more screening, wider prescribing of hepatitis C therapies such as DAA tablets, and earlier treatment of acute cases have led to a decline in acute hepatitis C cases. However, the reduction of cases still falls short of the World Health Organisation’s target of 90 per cent and reinfections remain high. The team believe that there is an on-going need to promote risk reduction and design appropriate screening policies for HIV positive men.
The team is expanding the study network to other centres with the ambition of collecting data nationally.