Prevalence and incidence of hepatitis C virus infection in men who have sex with men: a systematic review and meta-analysis

Jin, Fengyi; Dore, Gregory J.; Matthews, Gail V.; Luhmann, Niklas; Macdonald, Virginia; Bajis, Sahar; Baggaley, Rachel; Mathers, Bradley; Verster, Annette; Grulich, Andrew E.

doi:10.1016/s2468-1253(20)30303-4

Cited by 88 publications

(107 citation statements)

References 189 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nonetheless, our results clearly indicate the need for close follow-up in HIV/HCV-coinfected patients achieving SVR, as we also detected three reinfections in those patients. In line with previous reports from other centers, HIV-negative MSM on PrEP treatment seem to be at particularly high risk of HCV infection [ 5 , 6 ], which is corroborated by the fact that four out of five patients on PrEP included in our program finally tested positive for HCV-RNA; however, it is clear that this finding cannot be extrapolated to PrEP users in general.…”

Section: Discussionsupporting

confidence: 91%

“…Recently, the proportion of MSM accounted for about 30–40% of patients presenting with untreated HCV infection at our human immunodeficiency virus (HIV)/hepatitis outpatient clinic at the Vienna General Hospital (VGH). This is in line with reports from other European centers describing a high incidence/prevalence of HCV infection [ 3 ], even in times of unrestricted access to direct-acting antiviral (DAA) treatment [ 4 ], not only in HIV-positive MSM but also in HIV-negative MSM, especially if they take pre-exposure prophylaxis (PrEP) [ 5 , 6 ]. Unprotected anal intercourse and nasal and/or intravenous drug use are considered major modes of transmission for HCV in MSM, and respective risk behavior is commonly observed in the Viennese MSM population [ 7 ].…”

Section: Introductionsupporting

confidence: 84%

“…The MSM, in which high-risk sexual behavior is highly prevalent, have emerged as a population at particular risk of acquiring HCV (re)infections, possibly being at even higher risk for infection as compared to other risk populations, e.g. people who inject drugs (PWIDs) [ 6 ], especially if they take PrEP or have already contracted HIV [ 5 , 6 ]. The DAA treatment has proven to be highly efficient in MSM [ 1 ], even in patients with ongoing illicit drug use [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of an HCV elimination program targeting the Viennese MSM population

Jachs

Binter

Chromy

et al. 2021

Wien Klin Wochenschr

View full text Add to dashboard Cite

Summary Background and aims Recent reports suggest an increasing incidence of hepatitis C virus (HCV) infections among MSM (men-who-have-sex-with-men). Early treatment with direct-acting antivirals (DAAs) achieves high cure rates and prevents further HCV transmission. We offered barrier-free HCV screening in the Viennese MSM population and immediate access to DAA treatment. Methods In collaboration with gay health specialists, we screened for HCV seropositivity in Viennese MSM between 2019 and 2020. Barrier-free HCV-RNA-PCR tests, transient elastography (TE) and immediate access to DAA treatment were offered. Results A total of 310 HCV-seropositive patients were identified. Of those, 145 could be contacted and 109 attended their appointment at our clinic. HIV-coinfection was highly prevalent in our cohort (n = 86/145; 78.9%), while pre-exposure prophylaxis (PrEP) was taken by 21.7% (n = 5/23) of non-HIV patients. Sexual risk behavior and (history of) intravenous drug use was reported by 32.1% and 13.8% of patients, respectively. Most MSM had already achieved sustained virological response (SVR) to previous antiviral treatment (n = 72, 66.1%) or experienced spontaneous clearance (n = 10, 9.2%). Advanced fibrosis was only detected in 3/109 (2.8%) patients. 30 MSM tested positive for HCV-RNA and DAA treatment was initiated in 29 patients – all achieved SVR. Conclusion A targeted HCV test-and-treat program revealed a high prevalence of HCV seropositivity among Viennese MSM, potentially associated with high-risk sexual behavior and drug use. Early DAA treatment seems warranted in viremic HCV-MSM as SVR was 100%, which in turn prevents further HCV transmission.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of an HCV elimination program targeting the Viennese MSM population

Jachs

Binter

Chromy

et al. 2021

Wien Klin Wochenschr

View full text Add to dashboard Cite

show abstract

“…The last 10 years have seen a global epidemic of hepatitis C virus (HCV) among men who have sex with men (MSM), with the prevalence of HCV estimated at 1.5% in HIV‐negative MSM and 6.3% among HIV‐infected MSM 1,2 . Although HCV is a lifelong chronic infection, the development of direct‐acting antiviral (DAA) treatments for HCV allow for successful treatment, with cure rates over 90% even among HIV co‐infected individuals 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Existing initiatives to increase HCV screening and treatment among MSM in the UK and elsewhere have generally focussed on HIV‐diagnosed MSM in contact with care because of their frequent health service contact, 6 and their higher HCV incidence (~sixfold higher in the UK than in HIV‐negative MSM not using PrEP) 1 . However, significant HCV infection resides in HIV‐negative MSM (1.2% prevalence in UK in 2008/2009), 7 especially among those on HIV pre‐exposure prophylaxis (2.1% in PROUD study) 8 .…”

Section: Introductionmentioning

confidence: 99%

The cost‐effectiveness of case‐finding strategies for achieving hepatitis C elimination among men who have sex with men in the UK

MacGregor

Ward

Martin

et al. 2021

Journal of Viral Hepatitis

View full text Add to dashboard Cite

Modelling suggests hepatitis C virus (HCV) elimination is possible among men who have sex with men (MSM), with key screening groups including HIV‐diagnosed MSM and MSM using pre‐exposure prophylaxis (PrEP). Mathematical modelling was used to determine the cost‐effectiveness of HCV case‐finding strategies among MSM from the provider perspective, and to determine which interventions could achieve a 90% reduction in HCV incidence over 2015–2030. At baseline, we assumed symptomatic screening in HIV‐negative MSM (including PrEP users) and 12‐monthly screening among HIV‐diagnosed MSM. Improved case‐finding strategies included screening alongside HIV testing in HIV‐negative MSM not using PrEP (PrEP non‐users); 12/6/3‐monthly screening in PrEP users; and 6‐monthly screening in HIV‐diagnosed MSM, with the cost‐effectiveness being compared incrementally. Costs (GBP) and quality‐adjusted life years (QALYs) were assessed to estimate the mean incremental cost‐effectiveness ratio (ICER) with a time horizon to 2050, compared to a willingness‐to‐pay threshold of £20,000/QALY. From the baseline, the most incrementally cost‐effective strategy is to firstly undertake: (1) 12‐monthly HCV screening of PrEP users (gaining 6715 QALYs with ICER £1760/QALY), followed by (2) HCV screening among PrEP non‐users alongside HIV testing (gaining 7048 QALYs with ICER £4972/QALY). Compared to the baseline, this combined strategy would cost £46.9 (95%CrI £25.3–£66.9) million and achieve the HCV elimination target in 100% of model runs. Additional screening incurs ICERs >£20,000/QALY compared to this combined strategy. In conclusion, HCV elimination can be achieved cost‐effectively among UK MSM. Policymakers should consider scaling‐up HCV screening in HIV‐negative MSM, especially PrEP users, for achieving this target.

show abstract

Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender‐nonconforming

Kratzer,

Star,

Minihan

et al. 2024

Cancer

View full text Add to dashboard Cite

BackgroundIndividuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, or gender‐nonconforming (LGBTQ+) experience discrimination and minority stress that may lead to elevated cancer risk.MethodsIn the absence of population‐based cancer occurrence information for this population, this article comprehensively examines contemporary, age‐adjusted cancer risk factor and screening prevalence using data from the National Health Interview Survey, Behavioral Risk Factor Surveillance System, and National Youth Tobacco Survey, and provides a literature review of cancer incidence and barriers to care.ResultsLesbian, gay, and bisexual adults are more likely to smoke cigarettes than heterosexual adults (16% compared to 12% in 2021–2022), with the largest disparity among bisexual women. For example, 34% of bisexual women aged 40–49 years and 24% of those 50 and older smoke compared to 12% and 11%, respectively, of heterosexual women. Smoking is also elevated among youth who identify as lesbian, gay, or bisexual (4%) or transgender (5%) compared to heterosexual or cisgender (1%). Excess body weight is elevated among lesbian and bisexual women (68% vs. 61% among heterosexual women), largely due to higher obesity prevalence among bisexual women (43% vs. 38% among lesbian women and 33% among heterosexual women). Bisexual women also have a higher prevalence of no leisure‐time physical activity (35% vs. 28% among heterosexual women), as do transgender individuals (30%–31% vs. 21%–25% among cisgender individuals). Heavier alcohol intake among lesbian, gay, and bisexual individuals is confined to bisexual women, with 14% consuming more than 7 drinks/week versus 6% of heterosexual women. In contrast, prevalence of cancer screening and risk reducing vaccinations in LGBTQ+ individuals is similar to or higher than their heterosexual/cisgender counterparts except for lower cervical and colorectal cancer screening among transgender men.ConclusionsPeople within the LGBTQ+ population have a higher prevalence of smoking, obesity, and alcohol consumption compared to heterosexual and cisgender people, suggesting a higher cancer burden. Health systems have an opportunity to help inform these disparities through the routine collection of information on sexual orientation and gender identity to facilitate cancer surveillance and to mitigate them through education to increase awareness of LGBTQ+ health needs.

show abstract

Prevalence and incidence of hepatitis C virus infection in men who have sex with men: a systematic review and meta-analysis

Cited by 88 publications

References 189 publications

Outcomes of an HCV elimination program targeting the Viennese MSM population

Outcomes of an HCV elimination program targeting the Viennese MSM population

The cost‐effectiveness of case‐finding strategies for achieving hepatitis C elimination among men who have sex with men in the UK

Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender‐nonconforming

Contact Info

Product

Resources

About