Hepatitis C virus reinfection incidence and treatment outcome among HIV-positive MSM
- 23 October 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 27 (16), 2551-2557
- https://doi.org/10.1097/qad.0b013e32836381cc
Abstract
Objective: Liver disease secondary to hepatitis C virus (HCV) infection in the context of HIV infection is one of the leading non-AIDS causes of death. Sexual transmission of HCV infection among HIV-positive MSM appears to be leading to increased reports of acute HCV infection. Reinfection after successful treatment or spontaneous clearance is reported among HIV-positive MSM but the scale of reinfection is unknown. We calculate and compare HCV reinfection rates among HIV-positive MSM after spontaneous clearance and successful medical treatment of infection. Design: Retrospective analysis of HIV-positive MSM with sexually acquired HCV who subsequently spontaneously cleared or underwent successful HCV treatment between 2004 and 2012. Results: Among 191 individuals infected with HCV, 44 were reinfected over 562 person-years (py) of follow-up with an overall reinfection rate of 7.8/100 py [95% confidence interval (CI) 5.8–10.5]. Eight individuals were subsequently reinfected a second time at a rate of 15.5/100 py (95% CI 7.7–31.0). Combining all reinfections, 20% resulted in spontaneous clearance and treatment sustained viral response rates were 73% (16/22) for genotypes one and four and 100% (2/2) for genotypes two and three. Among 145 individuals with a documented primary infection, the reinfection rate was 8.0 per 100 py (95% CI 5.7–11.3) overall, 9.6/100 py (95% CI 6.6–14.1) among those successfully treated and 4.2/100 py (95% CI 1.7–10.0) among those who spontaneously cleared. The secondary reinfection rate was 23.2/100 py (95% CI 11.6–46.4). Conclusion: Despite efforts at reducing risk behaviour, HIV-positive MSM who clear HCV infection remain at high risk of reinfection. This emphasizes the need for increased sexual education, surveillance and preventive intervention work.This publication has 27 references indexed in Scilit:
- Hepatitis C virus clearance, reinfection, and persistence, with insights from studies of injecting drug users: towards a vaccineThe Lancet Infectious Diseases, 2012
- The More You Look, the More You Find: Effects of Hepatitis C Virus Testing Interval on Reinfection Incidence and Clearance and Implications for Future Vaccine Study DesignThe Journal of Infectious Diseases, 2012
- Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control StudyPLOS ONE, 2011
- Predicting spontaneous clearance of acute hepatitis C virus in a large cohort of HIV-1-infected menGut, 2010
- Sexually transmitted HCV infection and reinfection in HIV-infected homosexual menGastroentérologie Clinique et Biologique, 2009
- Natural History of Compensated Hepatitis C Virus–Related Cirrhosis in HIV‐Infected PatientsClinical Infectious Diseases, 2009
- Fast fibrosis progression between repeated liver biopsies in patients coinfected with human immunodeficiency virus/hepatitis C virusHepatology, 2009
- Delayed anti-HCV antibody response in HIV-positive men acutely infected with HCVAIDS, 2009
- Increase in diagnosed newly acquired hepatitis C in HIV-positive men who have sex with men across London and Brighton, 2002-2006: is this an outbreak?Sexually Transmitted Infections, 2008
- Behavioural predictors of subsequent hepatitis C diagnosis in a UK clinic sample of HIV positive men who have sex with menSexually Transmitted Infections, 2006