The HCV Epidemics in Key Populations (Including PWID, Prisoners, and MSM): The Use of DAAs as Treatment for Prevention

Purpose of Review

The burden of HCV is high among people who inject drugs (PWID) and prisoners, and increasing among HIV-infected men who have sex with men (MSM), who are key populations for HCV transmission in high-income countries, and may also play a role in many in low and middle-income countries. There is increasing interest in the use of HCV antiviral treatment for prevention in these populations.

Recent Findings

Numerous theoretical modeling studies have explored the potential impact of HCV treatment for prevention among PWID in a range of global settings, generally finding that modest and achievable levels of HCV treatment, especially with interferon-free direct acting antiviral therapy (IFN-free DAAs), could substantially reduce HCV chronic prevalence among PWID within the next 10–20 years. Additionally, modelling studies have shown HCV testing and treatment in prison (including prevention benefits) could be cost-effective if continuity of care is ensured, or HCV treatments are shortened with DAAs. Modelling work among HIV-infected MSM has shown that further HCV treatment scale-up is likely required despite high treatment rates in this population. However, no empirical studies have explored whether HCV treatment can reduce HCV prevalence and prevent onwards transmission among those at risk of transmission.

Summary

HCV treatment for key populations such as PWID, prisoners, and MSM could become an important HCV prevention intervention, especially in the IFN-free DAA era. However, there is an urgent need to test these hypotheses through empirical studies.

Full article at:  http://goo.gl/v7bPtX

By:  Natasha K. Martin,1,2 Peter Vickerman,2 Gregory Dore,3 and Matthew Hickman2

¹Division of Global Public Health, University of California San Diego, San Diego, USA

²School of Social and Community Medicine, University of Bristol

³Kirby Institute, UNSW Australia, Sydney

Corresponding Author: Natasha K Martin, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, California, 92093-0507. Email:ude.dscu@nitram-ahsataN, +1 858-822-4802

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