Reinfection with HCV Common in HIV-Positive Men Who Have Sex with Men

Men who are HIV positive and who have sex with other men (MSM) are experiencing an epidemic of sexually transmitted hepatitis C virus (HCV). The trend has been documented in Amsterdam and London and a newly reported study found that to be true in Western Europe as well.

According to research presented today at the International Liver Congress in Barcelona, these HIV-positive patients co-infected with HCV also tend to get re-infected after their HCV has been treated or in some cases, cleared spontaneously.

“HCV reinfection is an issue of major concern among HIV-positive MS, especially in light of increased costs of direct-acting antivirals,” T.C. Martin, of Chelsea and Westminster Hospital, London, UK and colleagues reported in paper presented today.

The finding could also give strength to concerns that pre-exposure prophylaxis (PREP) by MSM puts them at greater risk of getting other sexually transmitted diseases since PREP users have been shown to use condoms less frequently, despite advice that condom use is essential.

The UK team looked at 606 patients with a cured HCV infection in Western Europe. Of those, 24.6% later presented with a new HCV infection. In fact the reinfection incidence was higher among treated patients than among patients who had spontaneously cleared their infection (8.4 patient years per 100 vs. 4.6 patient years per 100.)

In the study the reinfected patients received treatment with ribavirin plus peg-interferon and achieved sustained viral response in 78% of the cases.

The researchers said “Prevention strategies are urgently needed for specific high-risk groups to reduce morbidity and treatment costs.”

They also recommend that patients in the MSM group be regularly tested for HCV infection every 3 to 6 months.