Theme: Epidemiology & Public Health Research Year: 2024
Background: Gay and bisexual men (GBM) with HIV are a key population group for hepatitis C virus (HCV) micro-elimination due to risk from sexual and substance use behaviours. Annual HCV testing is recommended but empirical testing rates are unknown. We aimed to examine HCV testing and positive tests among GBM with HIV across Australia since the availability of HCV direct-acting antivirals (2016-2022).
Methods: Using data from a sentinel surveillance clinical network of primary care, sexual health and hospital-based infectious disease clinics, we examined the proportion of GBM with ≥1 test, and of those the proportion with a positive test in each year for: 1) HCV antibody testing among GBM with no previous HCV positive test; 2) HCV RNA testing among GBM with a positive antibody test but no previous positive RNA test (initial RNA testing); and 3) HCV RNA testing among people who had a previous RNA positive test and a subsequent negative test (follow-up RNA testing). Logistic regression was used to examine trends from 2016-2019 and 2020-2022.
Results: Overall, 11,415 GBM with HIV had an HCV antibody and/or RNA test. From 2016 to 2019 antibody testing was stable averaging 55% and the proportion positive declined (2.0% -1.3%:OR 0.83,95%CI:0.74-0.92). Declines were observed for initial HCV RNA testing (75.4%-41.4%:OR 0.64,95%CI:0.58-0.72) and the proportion positive (44.8%-21.2%:OR 0.67,95%CI:0.57-0.79), and for HCV RNA follow-up testing (70.1%-44.5%:OR 0.69,95%CI:0.64-0.75) and proportion positive (11.3%-3.3%:OR 0.66,95%CI:0.53-0.84). There were very minimal or no changes from 2020 to 2022.
Conclusion: A substantial proportion of GBM with HIV are not tested for HCV annually. Though there has been a decline in positive tests since 2016, these occurred prior to 2020 with minimal or no change thereafter. Given new diagnoses have not declined since 2020, a focus on HCV testing, followed by prompt treatment where required, is warranted to achieve HCV elimination among GBM with HIV.
Disclosure of Interest Statement
The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses is funded by the Australian Government Department of Health and Aged Care. The funders had no role in the study design, analyses, interpretation, or the decision to submit.