TY - JOUR
T1 - Immediate treatment for recent hepatitis C infection in people with high-risk behaviors
T2 - a systematic review and meta-analysis
AU - Manoharan, Lakshmi
AU - Latham, Ned H.
AU - Munari, Stephanie C.
AU - Traeger, Michael W.
AU - Menon, Vinay
AU - Luhmann, Niklas
AU - Baggaley, Rachel
AU - Macdonald, Virginia
AU - Verster, Annette
AU - Siegfried, Nandi
AU - Matthews, Gail V.
AU - Stoové, Mark
AU - Hellard, Margaret E.
AU - Doyle, Joseph S.
N1 - Funding Information:
This work was supported by the World Health Organization Global Hepatitis Programme who commissioned and funded the project. Burnet Institute was supported by the Victorian Government Operational and Infrastructure Fund. Michael W. Traeger, Joseph S. Doyle, Margaret E. Hellard, and Mark Stoové were supported by the fellowship from the National Health and Medical Research Council.
Funding Information:
Michael W. Traeger, Joseph S. Doyle, Margaret E. Hellard, and Mark Stoové thank fellowship support from the National Health and Medical Research Council.
Publisher Copyright:
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.
PY - 2023/4
Y1 - 2023/4
N2 - Background and Aims: Direct-acting antivirals (DAAs) are almost exclusively approved for the treatment of chronic HCV. This poses a significant barrier to the treatment of recently acquired HCV because of the limited access to DAAs. This review seeks to address this issue by synthesizing evidence of the benefits and harms of immediate treatment after the detection of recently acquired HCV in people at higher risk of infection. Approach and Results: A systematic review and meta-analysis were conducted reporting on populations with recently acquired HCV at higher risk of infection. Studies were included if they assessed standard duration DAA treatment regimens and reported on the benefits and harms of immediate treatment (within one year of diagnosis). Outcomes included sustained virological response at 12 weeks post-treatment (SVR12), incidence, treatment initiation and adherence, overtreatment, engagement in care, and adverse events. Eight cohort studies, 3 open-label trials, and 1 case series study were included, reporting on 2085 participants with recently acquired HCV infection. No studies included a comparison group. Eight studies assessed DAA treatment in either men who have sex with men or men who have sex with men with HIV, 2 studies assessed treatment in people who inject drugs, and 2 among people living with HIV. Immediate treatment of HCV was associated with a pooled SVR12 of 95.9% (95% CI, 92.6%-99.3%). Three studies reported on hepatitis C incidence, where most participants were treated in the chronic phase of infection. A treatment completion rate of 100% was reported in 2 studies, and only 1 serious adverse event was described. Conclusions: High rates of cure were achieved with the treatment of recently acquired hepatitis C in people at higher risk of infection. Serious adverse events were rare, highlighting individual benefits consistent with the treatment of chronic hepatitis C. The impact of immediate treatment on HCV incidence requires further evaluation.
AB - Background and Aims: Direct-acting antivirals (DAAs) are almost exclusively approved for the treatment of chronic HCV. This poses a significant barrier to the treatment of recently acquired HCV because of the limited access to DAAs. This review seeks to address this issue by synthesizing evidence of the benefits and harms of immediate treatment after the detection of recently acquired HCV in people at higher risk of infection. Approach and Results: A systematic review and meta-analysis were conducted reporting on populations with recently acquired HCV at higher risk of infection. Studies were included if they assessed standard duration DAA treatment regimens and reported on the benefits and harms of immediate treatment (within one year of diagnosis). Outcomes included sustained virological response at 12 weeks post-treatment (SVR12), incidence, treatment initiation and adherence, overtreatment, engagement in care, and adverse events. Eight cohort studies, 3 open-label trials, and 1 case series study were included, reporting on 2085 participants with recently acquired HCV infection. No studies included a comparison group. Eight studies assessed DAA treatment in either men who have sex with men or men who have sex with men with HIV, 2 studies assessed treatment in people who inject drugs, and 2 among people living with HIV. Immediate treatment of HCV was associated with a pooled SVR12 of 95.9% (95% CI, 92.6%-99.3%). Three studies reported on hepatitis C incidence, where most participants were treated in the chronic phase of infection. A treatment completion rate of 100% was reported in 2 studies, and only 1 serious adverse event was described. Conclusions: High rates of cure were achieved with the treatment of recently acquired hepatitis C in people at higher risk of infection. Serious adverse events were rare, highlighting individual benefits consistent with the treatment of chronic hepatitis C. The impact of immediate treatment on HCV incidence requires further evaluation.
UR - https://www.scopus.com/pages/publications/85184410381
U2 - 10.1097/HC9.0000000000000082
DO - 10.1097/HC9.0000000000000082
M3 - Article
C2 - 36930865
AN - SCOPUS:85184410381
SN - 2471-254X
VL - 7
JO - Hepatology Communications
JF - Hepatology Communications
IS - 4
M1 - e0082
ER -
SDG 3 Good Health and Well-being