Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination
Abstract Background HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence...
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BMC
2017-12-01
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Online Access: | http://link.springer.com/article/10.1186/s12916-017-0979-1 |
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doaj-75627855eb75477cbaecd7bf52ba8c41 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Victor Virlogeux Fabien Zoulim Pascal Pugliese Isabelle Poizot-Martin Marc-Antoine Valantin Lise Cuzin Jacques Reynes Eric Billaud Thomas Huleux Firouze Bani-Sadr David Rey Anne Frésard Christine Jacomet Claudine Duvivier Antoine Cheret Laurent Hustache-Mathieu Bruno Hoen André Cabié Laurent Cotte the Dat’AIDS Study Group |
spellingShingle |
Victor Virlogeux Fabien Zoulim Pascal Pugliese Isabelle Poizot-Martin Marc-Antoine Valantin Lise Cuzin Jacques Reynes Eric Billaud Thomas Huleux Firouze Bani-Sadr David Rey Anne Frésard Christine Jacomet Claudine Duvivier Antoine Cheret Laurent Hustache-Mathieu Bruno Hoen André Cabié Laurent Cotte the Dat’AIDS Study Group Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination BMC Medicine HIV HCV Coinfection Treatment uptake Mathematical modeling Compartmental model |
author_facet |
Victor Virlogeux Fabien Zoulim Pascal Pugliese Isabelle Poizot-Martin Marc-Antoine Valantin Lise Cuzin Jacques Reynes Eric Billaud Thomas Huleux Firouze Bani-Sadr David Rey Anne Frésard Christine Jacomet Claudine Duvivier Antoine Cheret Laurent Hustache-Mathieu Bruno Hoen André Cabié Laurent Cotte the Dat’AIDS Study Group |
author_sort |
Victor Virlogeux |
title |
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
title_short |
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
title_full |
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
title_fullStr |
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
title_full_unstemmed |
Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
title_sort |
modeling hiv-hcv coinfection epidemiology in the direct-acting antiviral era: the road to elimination |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2017-12-01 |
description |
Abstract Background HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model. Methods The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups were considered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals, intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence data observed in the cohort between 2012 and 2015. Results On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosed patients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatment coverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalence among HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCV prevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalence in HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70% would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients would account for 34% of HCV infections in 2026. Conclusions Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most risk groups, including LR MSM. Elimination in HR MSM will require increased TC. |
topic |
HIV HCV Coinfection Treatment uptake Mathematical modeling Compartmental model |
url |
http://link.springer.com/article/10.1186/s12916-017-0979-1 |
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doaj-75627855eb75477cbaecd7bf52ba8c412020-11-25T01:04:20ZengBMCBMC Medicine1741-70152017-12-0115111110.1186/s12916-017-0979-1Modeling HIV-HCV coinfection epidemiology in the direct-acting antiviral era: the road to eliminationVictor Virlogeux0Fabien Zoulim1Pascal Pugliese2Isabelle Poizot-Martin3Marc-Antoine Valantin4Lise Cuzin5Jacques Reynes6Eric Billaud7Thomas Huleux8Firouze Bani-Sadr9David Rey10Anne Frésard11Christine Jacomet12Claudine Duvivier13Antoine Cheret14Laurent Hustache-Mathieu15Bruno Hoen16André Cabié17Laurent Cotte18the Dat’AIDS Study GroupDepartment of Hepatology, Croix-Rousse Hospital, Hospices Civils de LyonDepartment of Hepatology, Croix-Rousse Hospital, Hospices Civils de LyonDepartment of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’ArchetAix-Marseille University, APHM Hôpital Sainte-Marguerite, Service d’Immuno-hématologie clinique, INSERM U912 (SESSTIM)Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière HospitalCHU Toulouse, COREVIH ToulouseDepartment of Infectious Diseases, UMI 233 INSERM U1175, CHU de MontpellierDepartment of Infectious Diseases, Hotel-Dieu HospitalDepartment of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-DronDepartment of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, CHU ReimsHIV Infection Care Centre, Hôpitaux UniversitairesDepartment of Infectious Diseases, CHU Saint-EtienneDepartment of Infectious Diseases, CHU Clermont-FerrandDepartment of Infectious Diseases, Centre d’Infectiologie Necker-Pasteur, IHU Imagine, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants MaladesUniversité Paris Descartes, Sorbonne Paris Cité, EA7327Department of Infectious Diseases, CHRU de BesançonFaculté de Médecine Hyacinthe Bastaraud, Université des Antilles, and Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, and INSERM CIC 1424, Centre Hospitalier Universitaire de Pointe-à-PitreDepartment of Infectious Diseases, CHU de MartiniqueUniversité Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de LyonAbstract Background HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model. Methods The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups were considered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals, intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence data observed in the cohort between 2012 and 2015. Results On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosed patients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatment coverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalence among HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCV prevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalence in HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70% would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients would account for 34% of HCV infections in 2026. Conclusions Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most risk groups, including LR MSM. Elimination in HR MSM will require increased TC.http://link.springer.com/article/10.1186/s12916-017-0979-1HIVHCVCoinfectionTreatment uptakeMathematical modelingCompartmental model |