Keith Alcorn Published 27 April 2021 INFOhEP
The findings are published in the journal Open Forum Infectious Diseases.
Hepatitis C can be cured by a short course of direct-acting antiviral treatment and the World Health Organization has set targets for testing and treatment coverage by 2030 with the aim of eliminating hepatitis C. Left undiagnosed and untreated, hepatitis C may eventually lead to liver damage or liver cancer.
Hepatitis C elimination partially depends on targeting groups of people with high hepatitis C prevalence, such as people who inject drugs and people with HIV, through intensified screening, linkage to care and treatment. This strategy, known as micro-elimination, has demonstrated strong progress towards elimination targets in some countries, notably Switzerland and Spain.
In the United States, up to 30% of 1.1 million people living with HIV are estimated to be co-infected with hepatitis C. It’s unclear what proportion remain undiagnosed. The US Centers for Disease Control and Prevention (CDC), the HIV Medicine Association and the National Institutes of Health recommended routine testing for hepatitis C in people with HIV in 2009. In 2015 CDC recommended that people with HIV should be screened annually if they were at high risk of acquiring hepatitis C.
There is little information about how well this guidance is being implemented in the United States, especially among people at higher risk of hepatitis C acquisition.
Investigators from the HIV Outpatients Study set out to analyse hepatitis C testing in their own cohort among gay and bisexual men with HIV. Ongoing sexual transmission of hepatitis C is especially concentrated among gay and bisexual men who are HIV positive, due in part to condomless sex between men with HIV.
The HIV Outpatients Study follows people with HIV receiving HIV care at nine clinics in six large US cities. This analysis looked at all gay and bisexual men receiving at least two years of care at a participating clinic between 2011 and 2019. It excluded people who inject drugs or people who had already tested positive for hepatitis C antibodies.
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