BACKGROUND: Increasing numbers of hepatitis C virus (HCV) infections among men who have sex with men (MSM) are being observed in the Western world. The actual routes of HCV transmission during high-risk sex practices and associated drug use remain poorly understood. METHODS: Forty-seven patients with HCV were prospectively enrolled. Rectal and nasal swabs were collected to quantify HCV-RNA levels within rectal and nasal fluids. Contamination by occult rectal bleeding was excluded by guaiac paper test. Risk behavior was assessed by standardized questionnaires. RESULTS: Median age was 41.9 years, 89% were HIV positive (+) (42/47) and 85% (40/47) were male, 58% (23/40) of whom were MSM. Acute HCV infection was diagnosed in 32% (15/47) ,with all patients being HIV+MSM and 93% (14/15) having a documented history of sexually transmitted disease. Thirty-three (70%) patients had ≥1 HCV+ swab sample (HCV+SS; 48%, 22/46 rectal; 62%, 29/47 nasal), and contamination with blood was excluded in all patients. Individuals with HCV+SS had significantly higher serum HCV-RNA levels than patients with HCV-negative SS (6.28 [IQR, 0.85] log IU/mL vs 4.08 [2.45] log IU/mL; P < .001). Using ROC-curve analysis, serum HCV-RNA cutoffs for ruling in/out any HCV+SS were established at 6.02 log IU/mL and 4.02 log IU/mL, respectively. CONCLUSIONS: HCV-RNA is commonly detectable in rectal and nasal fluids of both HIV+ and HIV-negative HCV patients with high serum HCV-RNA, independently of the suspected route of HCV transmission. Accordingly, high-risk sex practices and sharing of nasal drug-sniffing "tools" might be important HCV transmission routes, especially in patients with high serum HCV-RNA.
BACKGROUND: Increasing numbers of hepatitis C virus (HCV) infections among men who have sex with men (MSM) are being observed in the Western world. The actual routes of HCV transmission during high-risk sex practices and associated drug use remain poorly understood. METHODS: Forty-seven patients with HCV were prospectively enrolled. Rectal and nasal swabs were collected to quantify HCV-RNA levels within rectal and nasal fluids. Contamination by occult rectal bleeding was excluded by guaiac paper test. Risk behavior was assessed by standardized questionnaires. RESULTS: Median age was 41.9 years, 89% were HIV positive (+) (42/47) and 85% (40/47) were male, 58% (23/40) of whom were MSM. Acute HCV infection was diagnosed in 32% (15/47) ,with all patients being HIV+MSM and 93% (14/15) having a documented history of sexually transmitted disease. Thirty-three (70%) patients had ≥1 HCV+ swab sample (HCV+SS; 48%, 22/46 rectal; 62%, 29/47 nasal), and contamination with blood was excluded in all patients. Individuals with HCV+SS had significantly higher serum HCV-RNA levels than patients with HCV-negative SS (6.28 [IQR, 0.85] log IU/mL vs 4.08 [2.45] log IU/mL; P < .001). Using ROC-curve analysis, serum HCV-RNA cutoffs for ruling in/out any HCV+SS were established at 6.02 log IU/mL and 4.02 log IU/mL, respectively. CONCLUSIONS:HCV-RNA is commonly detectable in rectal and nasal fluids of both HIV+ and HIV-negative HCVpatients with high serum HCV-RNA, independently of the suspected route of HCV transmission. Accordingly, high-risk sex practices and sharing of nasal drug-sniffing "tools" might be important HCV transmission routes, especially in patients with high serum HCV-RNA.
Authors: Lisa Steininger; David Chromy; David Bauer; Benedikt Simbrunner; Teresa Binter; Philipp Schwabl; Caroline Schmidbauer; Michael Trauner; Michael Gschwantler; Mattias Mandorfer; Thomas Reiberger Journal: Wien Klin Wochenschr Date: 2020-12-22 Impact factor: 1.704
Authors: Caroline Schmidbauer; David Chromy; Victor U Schmidbauer; Michael Schwarz; Mathias Jachs; David J M Bauer; Teresa Binter; Michael Apata; Dung T Nguyen; Mattias Mandorfer; Benedikt Simbrunner; Armin Rieger; Florian Mayer; Monika Breuer; Robert Strassl; Ralf Schmidt; Heidemarie Holzmann; Michael Trauner; Michael Gschwantler; Thomas Reiberger Journal: Liver Int Date: 2021-08-05 Impact factor: 8.754
Authors: David Chromy; David J M Bauer; Benedikt Simbrunner; Matthias Jachs; Lukas Hartl; Philipp Schwabl; Caroline Schwarz; Armin Rieger; Katharina Grabmeier-Pfistershammer; Michael Trauner; Peter Ferenci; Mattias Mandorfer; Michael Gschwantler; Thomas Reiberger Journal: J Viral Hepat Date: 2022-03-15 Impact factor: 3.517