‘Treatment as prevention’ works
The Swiss study added evidence to the frequent assertion at CROI that early treatment stops the spread of HCV.
The investigators screened 3,722 MSM from the Swiss HIV Cohort Study and found 178 (4.8%) men with replicating genotype 1 or 4 HCV infections. Of these cases, 31 were deemed incident and 147 chronic. Almost all the men agreed to treatment with standard-of-care DAAs, usually grazoprevir/elbasvir plus or minus ribavirin. Just about everyone had a sustained virologic response 12 weeks later.
The team rescreened the men after about a year, and found 28 infections; 16 were newly acquired, almost a 50% drop from baseline. The remaining 12 infections were chronic cases not treated earlier.
“Systemic screening followed by prompt DAA treatment can serve as a model to eliminate HCV in coinfected MSM,” said lead investigator Dominique Braun, MD, of the University of Zurich.
Dr. Boesecke is a consultant and/or speaker for AbbVie, Gilead Sciences, Janssen, Merck, and ViiV Healthcare. Dr. Thomas is a Merck consultant. Dr. Boerekamps and Dr. Braun’s studies were both funded by Merck, maker of elbasvir/grazoprevir.
SOURCE: Anne Boerekamps. 2018 CROI, Abstract 128. Christoph Boesecke. 2018 CROI, Abstract 129. Dominique Braun. 2018 CROI, Abstract 81LB.