PrEP Use Has Not Increased Hep-C in Australian Gay and Bi Men

A new study shows the rollout of PrEP among gay and bisexual men in Australia did not result in higher incidences of Hepatitis-C (HCV) as some had feared. Healio reported the EPIC-NSW study also found older men and those who used methamphetamine were more likely to report Hepatitis-C than others in the study.

“In implementing PrEP rollout, there was uncertainty about the impact that this would have on hepatitis C virus transmission in the community of gay and bisexual men in New South Wales,” said Janaki Amin, PhD, MPH, an epidemiologist and professor of public health at Macquarie University in Sydney.

Amin explained researchers were concerned the use of PrEP might change certain “risk behaviors associated with an increased risk of HCV,” as seen in other countries where PrEP is used, but their fears proved unfounded.

According to the report, just 20 participants in the study were diagnosed as acquiring Hepatitis-C during the study for a rate of 0.2 per 100. And those participating in the study who did acquire Hepatitis-C were significantly older (41 years versus 34 on average) and far more likely to use methamphetamine.

“PrEP rollout did not result in high levels of HCV incidence in our population,” Amin said. “With good engagement to care and appropriate HCV testing, in a setting of low HCV prevalence with access to HCV treatment, HCV could be eliminated in this population.”

EPIC-NSW is the Expanded PrEP Implementation in Communities in New South Wales, Australia project. The large-scale, three-year study of the efficacy of PrEP use is thought to be the first of its kind. The study found there was a decrease of roughly 40 percent in newly-reported early-stage instances of people living with HIV in NSW. The study also found those new instances occurred among those who did not take PrEP as directed, leading researchers to speculate PrEP could have an efficacy rate approaching 100 percent in adherent individuals.