Acute Hepatitis C Outbreak among HIV-infected Men, Madrid, Spain

Montoya-Ferrer, Ana

doi:10.3201/eid1708.110147

Cited by 15 publications

(18 citation statements)

References 12 publications

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“…40 All denied a history of injecting drug use, but CAI was identified as an important risk factor. Shortly afterwards, similar findings were echoed in other studies from major cities in Europe, [41][42][43][44][45][46][47][48][49][50] Australia, 51,52 and the US. 16,27 The number of cases in these reports ranged from 2 to 74 men.…”

Section: Case-series Reportssupporting

confidence: 72%

“…61,62 Some longitudinal studies in Europe demonstrated an increase in HCV incidence in HIV-positive GBM since the late 1990s. 34,35,63,64 Most of those who acquired acute HCV infection did not report a history of injecting drug use, 27,[41][42][43][44][45][46][47][48][49][50] with sexual contact being the mostly likely transmission route in these individuals. Behaviourally, this has coincided with the increasing practice of CAI and esoteric sexual practices, such as fisting, between partners of the same HIV status in the form of serosorting with the aim to minimise the HIV risk.…”

Section: Discussionmentioning

confidence: 99%

“…Until recently, 16,47 nearly all men in these cases were HIV positive. In 11 of these studies, over 90% of the men were non-IDUs, 27,[41][42][43][44][45][46][47][48][49][50] and co-diagnoses with ulcerative STIs were common, including syphilis, 40,[42][43][44]50 lymphogranuloma venereum (LGV) 42,46,50 and genital herpes. 44,50 Traumatic sexual practices were also frequently reported, particularly fisting.…”

Section: Case-series Reportsmentioning

confidence: 99%

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Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review

2017

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Abstract.A systematic review was performed on the evidence of sexual transmission of hepatitis C virus (HCV) in gay and bisexual men (GBM). Studies conducted in industrialised countries and published in English from 2000 to 2015 with data on HCV in GBM were included. Pooled estimates of prevalence and incidence of HCV infection were stratified by study settings and participants' HIV status using random effect models. Case-series reports were summarised descriptively. Of the 38 cross-sectional studies, the pooled HCV prevalence was substantially higher in HIV-positive men (8.3%, 95% CI: 6.7-9.9) than in HIV-negative men (1.5%, 95% CI 0.8-2.1), and higher in those who reported injecting drug use (34.8%, 95% CI 26.9-42.7) than in those who did not (3.5%, 95% CI 2.4-4.5). Of the 16 longitudinal studies, the pooled HCV incidence was markedly higher in clinic-based (7.0 per 1000 person-years, 95% CI 4.6-9.5) than in community-based (1.4 per 1000 person-years, 95% CI 0.7-2.1) studies, and in HIV-positive men (6.4 per 1000 person-years, 95% CI 4.6-8.1) than in HIV-negative men (0.4 per 1000 person-years, 95% CI 0-0.9). Since the early 2000s, 15 case-series reports increasingly pointed to the importance of sexual transmission of HCV in mainly HIV-positive men. Injecting drug use remained the major transmission route of HCV in GBM. Receptive condomless intercourse and concurrent ulcerative sexually transmissible infections are likely drivers that facilitated HCV sexual transmission in HIV-positive men. HCV incidence remains very low in HIV-negative GBM.

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Section: Case-series Reportssupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Case-series Reportsmentioning

confidence: 99%

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Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review

2017

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“…Since 2000, acute HCV infections have increasingly been reported among HIV-positive MSM in Europe, Australia and the United States [2][3][4][5][6][7][8][9]. Phylogenetic analysis has confirmed the existence of MSM-specific HCV transmission networks.…”

Section: Introductionmentioning

confidence: 93%

Trends in hepatitis C virus infections among MSM attending a sexually transmitted infection clinic; 1995–2010

Urbanus

Laar

Geskus

et al. 2014

Aids

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HCV prevalence among HIV-positive MSM significantly increased over calendar time but appears to level off in recent years, possibly due to increased awareness, saturation in the population, decreased risk behaviour and earlier HCV screening and treatment. The association with fisting became less strong over time, but our analyses continue to support sexual transmission. Monitoring HIV-positive and HIV-negative MSM for HCV infection remains needed to guide prevention efforts.

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“…HIVpositive men who have sex with men (MSM) appear to have the greatest risk for sexual transmission of HCV. Over the past decade there have been increasing reports of acute HCV outbreaks among HIV-positive MSM who denied IDU in Europe [23][24][25][26], Australia [27] and the United States [28,29]. Phylogenetic analyses have suggested that needle sharing was an unlikely source of infection in these outbreaks and that there is a unique HCV cluster among MSM [30,31].…”

Section: The Clinical Management Of Hcv In the Hiv-infected Patientmentioning

confidence: 99%

The Clinical Management of HCV in the HIV-Infected Patient

Norton

Naggie

2014

Antiviral Therapy

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Chronic hepatitis C affects an estimated 170 million persons worldwide and due to shared transmission routes many persons are coinfected with HIV. Since the advent of HAART, HIV patients have longer life expectancy and suffer fewer AIDS-related complications. The result has been an increase in morbidity and mortality from HIV-associated non-AIDS conditions, with high rates of liver-related deaths resulting from HCV in the coinfected population. Coinfection with HIV is an independent predictor of liver disease progression, and proper staging of fibrosis is of critical importance in the coinfected patient. In contrast to HIV, it is possible to eradicate HCV infection; and undetectable viral load 12 weeks after cessation of therapy, or sustained viral response (SVR), is considered a clinical cure. As achievement of SVR has been associated with significantly reduced mortality from liver disease and liver disease complications, it is imperative that patients coinfected with HIV-HCV receive therapy for their HCV infection. The length of therapy with previously available interferon-based regimens added a significant burden to HIV-HCV-coinfected patients. Newer, all-oral, interferon-free regimens promise to simplify treatment regimens, reduce side-effect profiles, and demonstrate reduced drug interactions with numerous HAART regimens.

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Acute Hepatitis C Outbreak among HIV-infected Men, Madrid, Spain

Cited by 15 publications

References 12 publications

Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review

Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review

Trends in hepatitis C virus infections among MSM attending a sexually transmitted infection clinic; 1995–2010

The Clinical Management of HCV in the HIV-Infected Patient

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