Format

Send to

Choose Destination
J Hepatol. 2017 Feb;66(2):282-287. doi: 10.1016/j.jhep.2016.09.004. Epub 2016 Sep 17.

HCV reinfection incidence and spontaneous clearance rates in HIV-positive men who have sex with men in Western Europe.

Author information

1
Center for Infectiology (CIB), Berlin, Germany. Electronic address: ingiliz@zibp.de.
2
Chelsea and Westminster Hospital, London, United Kingdom.
3
The Royal Free Hospital, London, United Kingdom.
4
Infectiology Center Hamburg (ICH), Hamburg, Germany.
5
Center for HIV and Hepatogastroenterology, Duesseldorf, Germany.
6
University of Bonn, Department of Medicine I, Bonn, Germany.
7
Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
8
Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, France.
9
Center for Infectiology (CIB), Berlin, Germany.
10
Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
11
Chelsea and Westminster Hospital, London, United Kingdom; Imperial College School of Medicine, London, United Kingdom.

Abstract

BACKGROUND & AIMS:

Moderate cure rates of acute hepatitis C virus (HCV) infections with pegylated interferon and ribavirin have been described in the last decade in men who have sex with men (MSM), who are also coinfected with the human immunodeficiency virus (HIV). However, a subsequent high incidence of HCV reinfections has been reported regionally in men who both clear the infection spontaneously or who respond to treatment.

METHODS:

Retrospective analysis of reinfections in HIV infected MSM in eight centers from Austria, France, Germany, and the UK within the NEAT network between May 2002 and June 2014.

RESULTS:

Of 606 individuals who cleared HCV spontaneously or were successfully treated, 149 (24.6%) presented with a subsequent HCV reinfection. Thirty out of 70 (43%) who cleared again or were successfully treated, presented with a second reinfection, 5 with a third, and one with a fourth reinfection. The reinfection incidence was 7.3/100 person-years (95% CI 6.2-8.6). We found a trend for lower incidence among individuals who had spontaneously cleared their incident infection than among individuals who were treated (Hazard ratio 0.62, 95% CI 0.38-1.02, p=0.06). Spontaneous clearance of reinfection was associated with ALT levels >1000IU/ml and spontaneous clearance of a prior infection.

CONCLUSIONS:

HCV reinfection is an issue of major concern in HIV-positive MSM. Prevention strategies are needed for high risk groups to reduce morbidity and treatment costs. HIV-positive MSM with a prior HCV infection should be tested every 3 to 6months for reinfection. Those who had achieved a reinfection should be tested every 3months.

LAY SUMMARY:

We evaluated the occurrence of HCV reinfection in HIV-positive men who have sex with men. We found an alarming incidence of 7.3/100 person-years. Prevention measures need to address this specific subgroup of patients at high risk for HCV.

KEYWORDS:

Acute hepatitis C; HCV reinfection; HCV therapy; HIV-HCV coinfection; SVR; Spontaneous clearance

PMID:
27650285
DOI:
10.1016/j.jhep.2016.09.004
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center