Sexual risk behavior ups acute HCV infections in HIV-negative MSM

  • Gras J & al.
  • AIDS
  • 1 Jan 2020

  • International Clinical Digest
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Takeaway

  • The incidence of acute hepatitis C virus (AHCV) infections is high among HIV-negative men who have sex with men (MSM) on preexposure prophylaxis (PrEP), highlighting screening needs.

Why this matters

  • Regardless of HIV status, more frequent HCV screening and diagnosis and timely treatment are recommended.

Key results

  • 429 participants; median follow-up duration, 2.1 (interquartile range [IQR], 1.5-2.8) years.
  • 14 participants (median age, 30 [IQR, 27-35] years) diagnosed with AHCV: 1 at entry, 13 incident cases.
  • HCV incidence: 1.40 (95% CI, 0.74-2.39) per 100 person-years.
  • 43% (n=6), 7% (n=1), and 50% (n=7) had HCV genotypes 1a, 3a, and 4d, respectively. 
  • Patients with AHCV reported a median of 17 (IQR, 8-30) sexual partners in the last 2 months vs 8 (IQR, 5-16) in uninfected individuals (P=.03), and median of 18 (IQR, 12-30) sexual acts during the last 4 weeks vs 10 (IQR, 5-16) in uninfected individuals (P=.02).
  • EIA HCV antigen, viral load test assays (Cobas HCV, Xpert HCV) had 100% sensitivity at diagnosis vs OraQuick (93% [95% CI, 66%-99%]), Toyo (79% [95% CI, 49%-45%]).

Study design

  • Subgroup analysis assessing AHCV incidence, infection risk factors, and testing sensitivity among high-risk MSM participating in the ANRS IPERGAY PrEP trial.
  • Funding: Inserm-ANRS; others

Limitations

  • Self-report bias.
  • Sexual risk behavior analyzed at inclusion only.
  • Underpowered.
  • Test assay performance overestimated.
  • Reinfection unassessed.