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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Recently acquired hepatitis C virus infection among people living with human immunodeficiency virus at a university hospital in Taiwan
Miao-Hui Huang, Hsin-Yun Sun, Shu-Yuan Ho, Sui-Yuan Chang, Szu-Min Hsieh, Wang-Huei Sheng, Yu-Chung Chuang, Yu-Shan Huang, Li-Hsin Su, Wen-Chun Liu, Yi-Ching Su, Chien-Ching Hung
Miao-Hui Huang, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970410, Taiwan
Hsin-Yun Sun, Szu-Min Hsieh, Wang-Huei Sheng, Yu-Chung Chuang, Yu-Shan Huang, Li-Hsin Su, Wen-Chun Liu, Yi-Ching Su, Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100008, Taiwan
Shu-Yuan Ho, Sui-Yuan Chang, Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100008, Taiwan
Sui-Yuan Chang, Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei 100233, Taiwan
Chien-Ching Hung, Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei 100233, Taiwan
Chien-Ching Hung, Department of Medical Research, China Medical University Hospital and China Medical University, Taichung 404394, Taiwan
Author contributions: Huang MH designed and performed the research; Sun HY and Hung CC designed the research and supervised the report; Ho SY and Chang SY provided laboratory support; Hung CC, Sun HY, Hsieh SM, Sheng WH, Chuang YC, Huang YS, Su LH, Liu WC, and Su YC were involved in the collection and assembly of clinical data; Huang MH and Hung CC participated in the data analysis and drafted the report; All authors reviewed and approved the final version of the report.
Supported by National Taiwan University Hospital, Taipei, Taiwan, No. NTUH106-003347 (to Sun HY).
Institutional review board statement: This retrospective study was approved by the Research Ethics Committee of National Taiwan University Hospital (registration number: 201605103RINC and 201605128RINC).
Informed consent statement: Written informed consents were obtained from all included participants prior to study inclusion.
Conflict-of-interest statement: The authors have no competing interest to disclose.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Chien-Ching Hung, MD, PhD, Professor, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei 100008, Taiwan. hcc0401@ntu.edu.tw
Received: April 5, 2021
Peer-review started: April 5, 2021
First decision: July 3, 2021
Revised: July 13, 2021
Accepted: September 2, 2021
Article in press: September 2, 2021
Published online: October 7, 2021
ARTICLE HIGHLIGHTS
Research background
Recently acquired hepatitis C virus (HCV) infections are increasingly reported in people living with human immunodeficiency virus (HIV) (PLWH) who are men who have sex with men. With availability of highly effective direct-acting antivirals (DAAs) for the treatment of HCV, microelimination HCV is considered an achievable goal in this at-risk population.
Research motivation
To achieve microelimination of HCV in PLWH, each step of the continuum of HCV care, from diagnosis, linkage to and engagement in care, initiation of anti-HCV treatment, treatment completion, to prevention against reinfection, is crucial. Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.
Research objectives
The study aimed to evaluate the care cascade of PLWH with recently acquired HCV infections at a university hospital designated for HIV care in Taiwan.
Research methods
The authors retrospectively reviewed the medical records of all PLWH testing negative for anti-HCV at baseline who developed anti-HCV seroconversion between 2011 to 2018 and were observed till the end of 2019. The number of people in each step of HCV care cascade was assessed and the duration between two sequential steps was estimated.
Research results
A total of 287 PLWH recently acquired HCV infections during the study period. High rates of linkage to HCV care and retention in the care were observed in our cohort. Compared with the interferon (IFN, 2011-2016) era, the barrier of referral to anti-HCV treatment assessment was diminished and the total duration of HCV viremia marked decreased in the direct-acting antiviral (DAA, 2017-2018) era.
Research conclusions
The achievement rates of engagement in each step of the HCV care cascade were high in both IFN and DAA eras and the barriers to referral and treatment initiation diminished over time.
Research perspectives
The impact of scale-up of HCV testing and DAA treatment after lifting the restriction on DAA reimbursement on the trends of incident HCV infections in PLWH warrants more long-term observation.
