BACKGROUND: Outbreaks of acute hepatitis C in HIV-positive men who have sex with men (MSM) are being reported in large cities in western countries along with increasing rates of sexually transmitted diseases. METHODS: All HIV individuals attended at a large outclinic in Madrid within the last 5 years were examined. Incident syphilis was diagnosed based on rapid plasma reagin (RPR) reactivity, being negative previously or showing >4-fold increase. Acute hepatitis C was diagnosed based on HCV antibody seroconversion and/or positive serum HCV-RNA after being negative within the last year. RESULTS: A total of 859 episodes of syphilis and 19 of acute hepatitis C were diagnosed during the study period. Syphilis was recognized in 65/2,094 (3.1%) individuals attended in 2008 and rose up to 261/2,512 (10.4%) in 2012 (P < 0.001). Acute hepatitis C was diagnosed in only one subject in 2008 but rose up to 7 in 2012 (P = 0.12). All 19 HIV patients with acute hepatitis C were MSM. Syphilis was diagnosed concomitantly in seven. All eight individuals who were treated with peginterferon/ribavirin were cured, whereas only one untreated experienced spontaneous clearance (P = 0.004). Two clusters of infections by HCV genotypes 4 and 1a were identified by phylogenetic analyses. CONCLUSIONS: The incidence of acute hepatitis C is low but steadily increasing in HIV-positive MSM in Madrid (<1% yearly), despite the very high rates of syphilis (currently 20% yearly in HIV-positive MSM). Preventive measures for sexually transmitted infections and periodic HCV screening are warranted in this population as treatment of acute hepatitis C is very effective.
BACKGROUND: Outbreaks of acute hepatitis C in HIV-positive men who have sex with men (MSM) are being reported in large cities in western countries along with increasing rates of sexually transmitted diseases. METHODS: All HIV individuals attended at a large outclinic in Madrid within the last 5 years were examined. Incident syphilis was diagnosed based on rapid plasma reagin (RPR) reactivity, being negative previously or showing >4-fold increase. Acute hepatitis C was diagnosed based on HCV antibody seroconversion and/or positive serum HCV-RNA after being negative within the last year. RESULTS: A total of 859 episodes of syphilis and 19 of acute hepatitis C were diagnosed during the study period. Syphilis was recognized in 65/2,094 (3.1%) individuals attended in 2008 and rose up to 261/2,512 (10.4%) in 2012 (P < 0.001). Acute hepatitis C was diagnosed in only one subject in 2008 but rose up to 7 in 2012 (P = 0.12). All 19 HIV patients with acute hepatitis C were MSM. Syphilis was diagnosed concomitantly in seven. All eight individuals who were treated with peginterferon/ribavirin were cured, whereas only one untreated experienced spontaneous clearance (P = 0.004). Two clusters of infections by HCV genotypes 4 and 1a were identified by phylogenetic analyses. CONCLUSIONS: The incidence of acute hepatitis C is low but steadily increasing in HIV-positive MSM in Madrid (<1% yearly), despite the very high rates of syphilis (currently 20% yearly in HIV-positive MSM). Preventive measures for sexually transmitted infections and periodic HCV screening are warranted in this population as treatment of acute hepatitis C is very effective.
Authors: Daniel Bradshaw; Jayna Raghwani; Brendan Jacka; Rachel Sacks-Davis; Francois Lamoury; Ian Down; Garrett Prestage; Tanya L Applegate; Margaret Hellard; Joe Sasadeusz; Gregory J Dore; Oliver G Pybus; Gail V Matthews; Mark Danta Journal: PLoS One Date: 2016-09-01 Impact factor: 3.240
Authors: Karin Neukam; Pompeyo Viciana; Guillermo Ojeda-Burgos; Marcial Delgado-Fernández; María J Ríos; Juan Macías; Dolores Merino; Antonio Collado; Francisco Téllez; Juan A Pineda Journal: BMC Infect Dis Date: 2016-09-15 Impact factor: 3.090
Authors: Joost W Vanhommerig; Femke A E Lambers; Janke Schinkel; Ronald B Geskus; Joop E Arends; Thijs J W van de Laar; Fanny N Lauw; Kees Brinkman; Luuk Gras; Bart J A Rijnders; Jan T M van der Meer; Maria Prins; J T M van der Meer; R Molenkamp; M Mutschelknauss; H E Nobel; H W Reesink; J Schinkel; M van der Valk; G E L van den Berk; K Brinkman; D Kwa; N van der Meche; A Toonen; D Vos; M van Broekhuizen; F N Lauw; J W Mulder; J E Arends; A van Kessel; I de Kroon; A Boonstra; M E van der Ende; S Hullegie; B J A Rijnders; T J W van de Laar; L Gras; C Smit; F A E Lambers; M Prins; J W Vanhommerig; W van der Veldt Journal: Open Forum Infect Dis Date: 2015-08-06 Impact factor: 3.835