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JAIDS Journal of Acquired Immune Deficiency Syndromes 04/2010; 53(4):547-50. · 4.43 Impact Factor
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ABSTRACT: Sexual transmission of hepatitis C (HCV) between HIV positive men who have sex with men (MSM) is increasingly being reported. There is limited and conflicting data as to whether HIV negative MSM are at increased risk of infection. Local directorate guidelines recommended HCV testing only in MSM having a sexual transmitted infection (STI) screen who disclosed risk factors. In 2007 we introduced unselected screening into routine practice within our sexual health clinics. This report reviews the results of this change in our practice. Over 6 months, 3365 MSM attended for STI screening. Of 2309 MSM who agreed to be screened for HCV (69%) the prevalence of HCV was 0.65% (95% CI 0.36-1.1). This is similar to the prevalence of HCV in the general population within England. We conclude that unselected screening of MSM for HCV within our sexual health services is not currently justified.
The Journal of infection 02/2010; 60(5):351-3. · 4.13 Impact Factor
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AIDS (London, England) 03/2009; 23(4):546-7. · 4.91 Impact Factor
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Journal of HIV therapy 04/2007; 12(1):7-10.
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ABSTRACT: Due to the asymptomatic nature of acute hepatitis C it can be difficult to diagnose in the early stage of infection, but with the higher treatment success rates and reduced treatment duration at this stage, it is imperative that diagnoses are made. Therefore, physicians should routinely screen at-risk individuals and investigate abnormal liver function tests. Serum HCV RNA should be considered in any HCV-antibody-negative individual in whom acute HCV is clinically suspected, or annually in those high-risk individuals with previous infection. Acute hepatitis C transmission may be facilitated by the presence of an erosive genital lesion, such as syphilis or lymphogranuloma venereum, and thus testing at this time should be encouraged. Reinfection with HCV does occur and patients need to be informed of the sexual and other high-risk behaviors that put them at risk of reinfection. Public awareness of the possibility of HCV infection, and subsequent reinfection, in high-risk groups should be increased. The question of the optimal treatment regimen is still disputed. However, ongoing trials and the proposed randomized controlled trial from the European AIDS Treatment Network should answer many of our questions. In the meantime, units faced with HIV/acute hepatitis C coinfection should follow recommendations from the HCV-HIV International Panel.
AIDS reviews 10(4):245-53. · 3.51 Impact Factor
