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Co-EC Study: Eliminating hepatitis C/HIV coinfection

The co-EC study aimed to eliminate hepatitis C/HIV coinfection among gay and bisexual men through scale up treatment of Hepatitis C in primary care and hospital settings.This study involved an open label, non-randomised clinical trial of hepatitis C treatment for people with HIV coinfection.

Hepatitis C virus (HCV) infection is a significant health issue among individuals with human immunodeficiency virus (HIV) infection and has been associated with more rapid progression to HCV-related liver disease and increased risk for cirrhosis and liver cancer. In Victoria Australia, the highest prevalence of HCV/HIV co-infection is in gay and bisexual men.

The advent of directly acting antiviral (DAA) treatment provides us with a unique opportunity to increase the number of people accessing hepatitis C treatment. In most cases, new DAA treatment offers shorter treatment times and fewer side effects than previous HCV treatment. Importantly it is likely that the treatment could be administered in the primary health care setting improving treatment capacity and accessibility, whilst potentially reducing treatment costs.

The study ran for 36 months, including 18 months for recruitment and treatment and 12 months follow-up, from April 2016 - 2019.

Treatment involved any combination of hepatitis C antiviral therapy approved for use in Australia appropriate for the participants’ hepatitis C genotype. All participants received open label hepatitis C treatment selected at the decision of their treating clinicians.
 
Treatment was based at six clinics in Melbourne, including both HIV primary care clinics and specialist clinics:

  • The Alfred Hospital, Melbourne
  • Melbourne Sexual Health Centre, Carlton
  • Prahran Market Clinic, Prahran
  • Royal Melbourne Hospital, Parkville
  • Centre Clinic, St Kilda
  • Northside Clinic, North Fitzroy.

This study offered proof of concept that scaling up treatment could lead to elimination of HCV/HIV co-infection in gay and bisexual men by treating prevalent infection thereby reducing new primary infections and re-infection.

Square Margaret Hellard 210X210

Professor Margaret Hellard AM

Contact Professor Margaret Hellard AM for more information on this project.

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Publications

Cohort Profile: International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC)

van Santen DK, Stewart A, Doyle JS, Stoové MA, Asselin J, Klein MB, Young J, Berenguer J, Jarrin I, Lacombe K, Wittkop L, Leleux O, Salmon D, Bonnet F, Rauch A, Mugglin C, Matthews G, Prins M, Smit C, Boyd A, van der Valk M, Sacks-Davis R, Hellard ME; InCHEHC Study Group.(2024)
International Journal of Epidemiology 

Reasons for not commencing direct-acting antiviral treatment despite unrestricted access for individuals with HIV and hepatitis C virus: a multinational, prospective cohort study

Isfordink CJ, Boyd A, Sacks-Davis R, van Santen DK, Smit C, Martinello M, Stoove M, Berenguer J, Wittkop L, Klein MB, Rauch A, Salmon D, Lacombe K, Stewart A, Schinkel J, Doyle JS, Hellard M, van der Valk M, Matthews GV, InCHEHC study group (2023)
The Lancet, Public Health

Funding
Partners

  • Bristol-Myers Squibb

Partners +
Collaborators

  • The Alfred Hospital