Article

Acute hepatitis C in HIV-infected men who have sex with men: An emerging sexually transmitted infection

Cluster of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands.
AIDS (London, England) (Impact Factor: 5.55). 07/2010; 24(12):1799-812. DOI: 10.1097/QAD.0b013e32833c11a5
Source: PubMed

ABSTRACT

Since 2000 outbreaks of acute hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM) who denied injecting drug use have been reported from Europe, the United States, Canada and Australia. Given the burden of liver disease, in particular HCV, on the morbidity and mortality in HIV patients in the era of combination antiretroviral therapy, the rapid and significant rise in the incidence of HCV in the HIV-infected MSM population in high-income countries is alarming. This relates to a significant change in the epidemiology of HCV that has occurred, with HCV emerging as a sexually transmitted infection within this population. Work to date suggests that this permucosal HCV transmission results from high-risk sexual and noninjecting drug use behaviours, reopening the discussion on the importance of sexual transmission. Given this occurs almost exclusively in HIV-infected MSM, HIV probably has a critical role mediated either through behavioural and/or biological factors. Finally, the management of acute HCV in HIV infection is complicated by concomitant HIV infection and combination antiretroviral therapy. This review will synthesize the most recent epidemiological, immunological and management issues that have emerged as a result of the epidemic of acute HCV among HIV-infected MSM.

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    • "Natural history of chronic infectious liver disease Hepatitis C Prior to 1990, before routine screening of donated blood for HCV, patients at highest risk for acquiring acute hepatitis C included those who received blood transfusions, blood products or anti-D immunoglobulin in pregnancy, intravenous drug users, tattoo or body piercing recipients under unsterile conditions, heath care workers, dialysis patients, and those partaking in " high risk " sexual activities[1]. After the introduction of routine screening of blood products, the demographic profile of newly infected patients changed to predominantly those who use intravenous drugs and homosexual men[10]. For those who are infected, the acute phase is often unrecognized, as patients are typically asymptomatic or have mild, viral flu-like complaints. "
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    • "Determinants for HCV transmission are recreational drug use, sharing of snorting straws, receptive fisting, ulcerative sexually transmitted infections such as syphilis, group sex, and rectal trauma with bleeding [22,30–32]. There are also a number of potential mechanisms related to HIV that might result in enhanced infectivity of and susceptibility to HCV, including increased HCV loads in serum and semen, and defects in the gastrointestinal immune system [33]. Despite adequate surveillance systems, there is still a significant fraction (up to 45%) of acute HCV infections for which the mode of transmission cannot be identified. "
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    ABSTRACT: Within the Dutch Acute HCV in HIV Study, a surveillance system was initiated to estimate the incidence of hepatitis C virus (HCV) infections in 2014. Following the Dutch HIV treatment guidelines, HIV-positive men having sex with men (MSM) in 19 participating centers were screened. Ninety-nine acute HCV infections were reported, which resulted in a mean incidence of 11 per 1000 patient-years of follow-up. Unfortunately, the HCV epidemic among Dutch HIV-positive MSM is not coming to a halt. © 2015 European Society of Clinical Microbiology and Infectious Diseases.
    Full-text · Article · Oct 2015 · Clinical Microbiology and Infection
    • "Determinants for HCV transmission are recreational drug use, sharing of snorting straws, receptive fisting, ulcerative sexually transmitted infections such as syphilis, group sex, and rectal trauma with bleeding [22,30–32]. There are also a number of potential mechanisms related to HIV that might result in enhanced infectivity of and susceptibility to HCV, including increased HCV loads in serum and semen, and defects in the gastrointestinal immune system [33]. Despite adequate surveillance systems, there is still a significant fraction (up to 45%) of acute HCV infections for which the mode of transmission cannot be identified. "
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    No preview · Article · Apr 2015 · Clinical Microbiology and Infection
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