7th International AIDS Society Conference, Kuala Lumpur, June 2013:
Results from a study in London shows a high rate of re-infection with hepatitis C (HCV) in 858 gay men living with HIV. A total of 145 men were followed who had a documented date of an initial HCV infection.
Earlier studies have shown sexual re-infection of HCV in HIV-positive gay men in several large cities, such as New York, Paris, Amsterdam and London. Although hepatitis C is not generally regarded as a sexually transmitted infection (STI), more data are showing this may not be the case for people with HIV and particularly for sexually active HIV-positive gay men. Risk factors for transmission include active STIs, drug use, and types of sex that allows for blood-to-blood contact including unprotected anal sex.
The study covered the years 2004–2012 and found that 1 in 4 men had been re-infected with HCV within two years of either spontaneously clearing the initial infection (1 in 5 men) or successful treatment to it (73% for genotypes 1/4, 100% for genotypes 2/3). Second re-infections also occurred in 8 men.
These data point to two main issues for providers of medical care. First, routine screening for hepatitis C should continue for sexually active HIV-positive individuals even after successful treatment or clearance. Second, enhanced education efforts should occur in this population to highlight the importance of preventing re-infection.
ABSTRACT
T Martin, N Martin, M Hickman, et al. HCV reinfection among HIV-positive men who have sex with men. 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013). Kuala Lumpur, June 30-July 3, 2013.
For more detailed discussion on this topic, go to HIVandHepatitis.com.