Hepatitis C incidence low among gay and bisexual men on PrEP, study finds
There were few incident hepatitis C virus infections recorded among gay and bisexual men participating in an HIV PrEP rollout study in Australia, researchers reported.
The EPIC-NSW study has produced some major findings in the past, including that the rollout of PrEP in the state of New South Wales led to a rapid decline in new HIV infections. Other results from the study suggest that the connection between PrEP and STIs may be overestimated.
“In implementing PrEP rollout, there was uncertainty about the impact that this would have on hepatitis C virus transmission in the community of gay and bisexual men in New South Wales,” Janaki Amin, PhD, MPH, an epidemiologist and professor of public health at Macquarie University in Sydney, Australia, told Healio.
“It was thought PrEP for HIV could result in a change in risk behaviors associated with an increased risk of HCV,” Amin said. “In countries with a higher prevalence than Australia of HCV among HIV-negative gay and bisexual men, there is a concerning incidence of HCV for men on PrEP.”
EPIC-NSW — the acronym stands for Expanded PrEP Implementation in Communities–New South Wales — was a cohort study that recruited 9,596 people at high risk for HIV from 31 clinics in New South Wales and the Australian Capital Territory.
According to Amin and colleagues, at least one HCV test result was available for 90.2% of participants. Prior HCV exposure was detected among 0.9% of those participants at baseline (95% CI, 0.7%-1.2%), and just 20 participants were diagnosed with incident HCV infection, a rate of 0.2 per 100 person-years (95% CI, 0.1-0.3), the researchers reported.
According to the study, participants diagnosed with incident HCV were significantly older (median age of 41 years vs. 34 years, P = .044) and more likely to report methamphetamine use at baseline (incidence rate ratio = 2.7; 95% CI, 1-7.2) than those without incident infection.
“PrEP rollout did not result in high levels of HCV incidence in our population,” Amin said. “With good engagement to care and appropriate HCV testing, in a setting of low HCV prevalence with access to HCV treatment, HCV could be eliminated in this population.”