Targeted HCV core antigen monitoring among HIV-positive men who have sex with men is cost-saving

By S tephanie Popping  Dr. Brooke Nichols  |  | 

Introduction: The World Health Organization declared the goal of hepatitis C virus (HC V) elimination by 2030. Micro-elimination, which is the reduction of incidence to zero in targeted populations, is less complex and costly and may be the first step to prove whether elimination is feasible. A suitable target group is HI V-positive men who have sex with men (MSM) because of their high-risk behavior and high incidence rates. Moreover, HC V monitoring is integrated in HI V care. The current HC V monitoring approach is suboptimal and complex and may miss new HC V infections. Alternative monitoring strategies, based on alanine aminotransferase, HC V-PCR and HC V-core antigen (HC V-cAg), combined with immediate direct-acting antiviral (DAA ) treatment, may be more effective in reducing new HC V infections.
Methods: A deterministic mathematical transmission model was constructed representing the Dutch HC V epidemic among HI V-positive MSM to compare different HC V monitoring strategies from 2018 onwards. We evaluated the epidemiological impact of alternative and intensified monitoring in MSM with HC V. In addition, the cost-effectiveness was calculated over a lifetime horizon.

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