Session topic


Title: Monitoring of new HIV diagnoses reveals a significant increase in the proportion of resolved HCV coinfections, but PWIDs lack behind
ID: PS 100
Type: Poster session
Talk time: 3 + 2 min
Session: Poster session 2
Epidemiology and disease ecology

Speaker: Daniel Ivanusic (Berlin/DE)

Abstract - Text

Abstract text (incl. references and figure legends)

Introduction & Objective: In light of the paradigm shift in HCV therapy, we performed a study on HCV infections in newly reported HIV diagnoses in Germany between 2009-2019. The study aims to provide public health information to better characterize groups at risk for HIV/HCV coinfection and to analyze the benefit of therapies with direct acting antivirals (DAA) in those groups.

Material & Methods: We obtained dried plasma spots from new HIV diagnoses along with the statutory report to the RKI. The analyzed samples represent 48.0% of all cases in the study period. Samples were initially screened for anti-HCV antibodies/HCV antigen by ELISA (HCV Monolisa, BioRad). Reactive samples were further screened by an in-house qPCR to discriminate between viraemic and resolved infections. Samples negative for HCV-RNA were confirmed by Western blot. An HCV recency assay was applied to identify HCV infections in viraemic cases acquired less than a year before HIV-diagnosis.

Results: Of the 16.539 analyzed new HIV diagnoses 6.2% (n=1.018) were positive for HCV antigen and/or anti-HCV antibodies which is about 20-fold higher than presumed in the general population. People who inject drugs (PWIDs) were the risk group with the highest prevalence of HCV/HIV coinfections in the study (73.7%; 446/605), while only 2.6% (235/9.153) of men who have sex with men (MSM) were HCV coinfected. From 90.1% of HCV cases (917/1.018), material was available to screen for HCV-RNA. Of those 33.0% (303/917) were HCV-RNA negative representing resolved infections. The proportion of such cases increased from 24.3% in 2016 to 48.2% in 2019. The highest proportion of resolved cases with 40% (76/190) and the most significant increase up to 70.6% in 2019 was observed in the group of MSM. In contrast, among PWIDs the rate of resolved HCV infections was 29.5% (124/421). This group showed also the lowest increase since 2016 (45% in 2019). The proportion of recent HCV infections was 27.3% (77/282) in PWIDs and 34.6% (37/107) in MSM. The average recency in the study was 29.6% (174/587).

Conclusion: The still low prevalence of resolved HCV coinfections in PWIDs in comparison to MSM and other transmission groups indicates that PWIDs lag behind regarding the benefits of DAAs. The recency data indicate a lower testing frequency for HCV infections in PWIDs that needs to be improved.