Ian Lockart1,2, Gail V Matthews3, Mark Danta1,2. 1. St Vincent's Clinical School, Faculty of Medicine. 2. Department of Gastroenterology, St Vincent's Hospital, Sydney, New South Wales, Australia. 3. Viral Hepatitis Clinical Research Program, Kirby Institute, UNSW.
Abstract
PURPOSE OF REVIEW: The scale-up of direct-acting antiviral (DAA) therapy and introduction of preexposure prophylaxis (PrEP) has changed the epidemiology of sexually acquired hepatitis C virus (HCV) amongst HIV-positive and HIV-negative MSM. RECENT FINDINGS: Sexually acquired HCV continues to occur predominantly amongst HIV-positive MSM. Despite an increased uptake of DAA therapy the incidence of acute HCV has not declined consistently amongst HIV-positive MSM, likely a result of high infection and reinfection rates. Increasing cases of sexually acquired HCV have been reported amongst HIV-negative MSM accessing PrEP. Despite a lower prevalence of HCV at baseline, HIV-negative MSM accessing PrEP have an equally high overall incidence of HCV compared with HIV-positive MSM during follow-up. Behavioural factors (high-risk sexual behaviours and sexualized drug use) appear to be driving this HCV epidemic amongst MSM and effective behavioural interventions and early identification of reinfections are essential to control the HCV epidemic amongst MSM. SUMMARY: An improved understanding of the epidemiology of sexually acquired HCV will allow implementation of more effective public health interventions to control the transmission of HCV amongst HIV-positive and HIV-negative MSM.
PURPOSE OF REVIEW: The scale-up of direct-acting antiviral (DAA) therapy and introduction of preexposure prophylaxis (PrEP) has changed the epidemiology of sexually acquired hepatitis C virus (HCV) amongst HIV-positive and HIV-negative MSM. RECENT FINDINGS: Sexually acquired HCV continues to occur predominantly amongst HIV-positive MSM. Despite an increased uptake of DAA therapy the incidence of acute HCV has not declined consistently amongst HIV-positive MSM, likely a result of high infection and reinfection rates. Increasing cases of sexually acquired HCV have been reported amongst HIV-negative MSM accessing PrEP. Despite a lower prevalence of HCV at baseline, HIV-negative MSM accessing PrEP have an equally high overall incidence of HCV compared with HIV-positive MSM during follow-up. Behavioural factors (high-risk sexual behaviours and sexualized drug use) appear to be driving this HCV epidemic amongst MSM and effective behavioural interventions and early identification of reinfections are essential to control the HCV epidemic amongst MSM. SUMMARY: An improved understanding of the epidemiology of sexually acquired HCV will allow implementation of more effective public health interventions to control the transmission of HCV amongst HIV-positive and HIV-negative MSM.
Authors: Aldemir B Oliveira-Filho; Diego Wendel F Aires; Natalia S Cavalcante; Nairis Costa Raiol; Brenda Luena A Lisboa; Paula Cristina R Frade; Luana M da Costa; Luiz Marcelo L Pinheiro; Luiz Fernando A Machado; Luisa C Martins; Gláucia C Silva-Oliveira; João Renato R Pinho; Emil Kupek; José Alexandre R Lemos Journal: Pathogens Date: 2019-11-14
Authors: Andreia Alves de Andrade; Ágabo Macêdo da Costa E Silva; Megmar Aparecida Dos Santos Carneiro; Sheila Araújo Teles; Regina Maria Bringel Martins Journal: Braz J Infect Dis Date: 2019-07-22 Impact factor: 3.257