Micro-elimination of hepatitis C virus (HCV) in people living with HIV (PLHIV) and co-infected with HCV has been proposed as a key contribution to the overall goal of HCV elimination. While other studies have examined micro-elimination in HIV treated cohorts, few have considered HCV micro-elimination among those not treated for HIV or at a national level.
Through data linkage of national and sentinel surveillance data, we examined extent of HCV testing, diagnosis, and treatment among a cohort of PLHIV in Scotland identified through the national database of HIV diagnosed individuals, to the end of 2017.
Of 5018 PLHIV, an estimated 797 (15%) had never been tested for HCV and 70 (9%) of these had undiagnosed chronic HCV. Odds of never being tested for HCV were highest in those not on HIV treatment (adjusted Odds Ratio = 7.21, 95% CI 5.15- 10.10). Overall HCV antibody positivity was 11% and highest among people who inject drugs (PWID) at 49%. Most (91%) of those with chronic HCV had attended an HCV treatment clinic but only half had been successfully treated (54% for those on HIV treatment, 12% for those not) by the end of 2017. Odds of never being treated for HCV were highest in those not on HIV treatment (aOR= 3.60, 95% CI 1.59 - 8.15).
Our data demonstrate that micro-elimination of HCV in PLHIV is achievable but progress will require increased effort to engage and treat those co-infected, including those not being treated for their HIV.
|Publication status||Accepted/In press - 28 Oct 2020|