Project R-7861

Hepatitis C virus direct acting antiviral (DAA) treatment success and its impact on transmission dynamics in HIV/HCV co-infected MSM (Research)

Globally, 3-4 million hepatitis C virus (HCV) infections occur annually with injecting drug users (IDUs) and HIV positive men-who-have-sex-with-men (MSM) at highest risk. While spontaneous clearance occurs, the majority develops chronic infection with risk for cirrhosis, end-stage liver disease and hepatocellular carcinoma. In MSM, HCV transmission routes are unclear but concurrent IDU, coinfection with HIV and high-risk sexual practices are probable determinants. In this new era of direct acting antivirals (DAA), clearance rates of treated HCV infection are >90%. However, successful treatment does not preclude patients from persisting their risk behaviour leading to reinfection, which reduces the long-term DAA-attributable impact on the dynamics of HCV spread at population level. Therefore the aim of this study is to investigate transmission characteristics of HCV at (re) infection in Belgian MSM treated with or starting DAA. We will collate clinical, demographic, riskbehaviour, epidemiological and viral data from different study populations in Belgium. Phylogenetic transmission clusters and predictors for treatment success, resistance and reinfection will be determined and used to help construct innovative mathematical transmission models allowing to predict the long-term efficacy of DAA and its impact on disease dynamics. The resulting epidemiological HCV models will have direct relevance to clinicians and policy-makers in the field of public health and HCV management.

01 January 2017 - 31 December 2020