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New hepatitis C infections among HIV-positive gay men drop by half after direct-acting antiviral roll-out in Netherlands
Liz Highleyman, 2017-02-17 12:10:00

A little more than a year after the Netherlands instituted a policy allowing unrestricted access to direct-acting antivirals for the treatment of hepatitis C, researchers have already seen a dramatic decline in acute hepatitis C virus (HCV) infections among one at-risk population, HIV-positive men who have sex with men.

These findings were reported on Thursday at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) in Seattle, in a session that also included presentations on rising incidence of HCV infection among HIV-positive gay men in San Diego and predictions about eradication of HIV/HCV co-infection in France.

Starting in the early 2000s researchers began to report outbreaks of acute hepatitis C in European cities. Although sexual transmission of HCV is rare overall, it occurs more often among HIV-positive men who have sex with men (MSM).

The advent of direct-acting antivirals (DAAs) used in interferon-free regimens has made hepatitis C treatment faster, easier and much more effective, with cure rates exceeding 90%. Promptly treating everyone infected with HCV, especially those in high-risk groups such as sexually active gay men and people who continue to inject drugs, could cut transmission – a concept known as 'treatment as prevention'. But in many countries access to DAAs has been limited due to their high cost, including restrictions around liver disease severity and abstinence from drugs or alcohol.