Sexually transmitted hepatitis C virus infections: current trends, and recent advances in understanding the spread in men who have sex with men.
Open accessAbstract
INTRODUCTION: Hepatitis C virus (HCV) is a major public health threat. Although the recent availability of highly effective directly acting antivirals created optimism towards HCV elimination, there is ongoing transmission of HCV in men who have sex with men (MSM). We here report current epidemiological trends and synthesise evidence on behavioural, network, cellular and molecular host factors associated with sexual transmission of HCV, in particular the role of HIV-1 co-infection. We discuss prevention opportunities focusing on the potential of HCV treatment. METHODS: We searched MEDLINE, fact sheets from health professional bodies and conference abstracts using appropriate keywords to identify and select relevant reports. RESULTS AND DISCUSSION: Recent studies strongly suggest that HCV is transmitted via sexual contact in HIV-positive MSM and more recently in HIV-negative MSM eligible for or on pre-exposure prophylaxis. The reinfection risk following clearance is about 10 times the risk of primary infection. International connectedness of MSM transmission networks might contribute to ongoing reinfection. Some of these networks might overlap with networks of people who inject drugs. Although, the precise mechanisms facilitating sexual transmission remain unclear, damage to the mucosal barrier in the rectum could increase susceptibility. Mucosal dendritic cell subsets could increase HCV susceptibility by retaining HCV and transmitting the virus to other cells, allowing egress into blood and liver. Early identification of new HCV infections is important to prevent onward transmission, but early diagnosis of acute HCV infection and prompt treatment is hampered by the slow rate of HCV antibody seroconversion, which in rare cases may take more than a year. Novel tests such as testing for HCV core antigen might facilitate early diagnosis. CONCLUSIONS: High-risk sexual behaviour, network characteristics, co-infection with sexually transmitted infections like HIV-1 and other concomitant bacterial and viral sexually transmitted infections are important factors that lead to HCV spread. Targeted and combined prevention efforts including effective behavioural interventions and scale-up of HCV testing and treatment are required to halt HCV transmission in MSM.
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Increasing incidence of acute HCV infection among MSM with HIV infection has been reported in multiple U.S. and European cities.
“Increasing incidence of acute HCV infection among MSM with HIV infection has been reported in multiple U.S. (96,236,239,1339) and European cities (237,1340–1342).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1341]
The Methods section, ‘Epidemiology of sexually transmitted HCV’ (page unavailable), reports rising HCV incidence among HIV-positive MSM overall and in northern Europe, while noting that incidence has stabilized in western Europe. It mentions HCV transmission networks in the United States but does not report increasing incidence across multiple U.S. cities. The geographic scope of the claim is therefore only partly supported. (LLM, conf=0.85)
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- Authors
- Nijmeijer, B. M., Koopsen, J., Schinkel, J., Prins, M., & Geijtenbeek, T. B.
- Affiliations
- Amsterdam University Medical Centers (NL)
- GGD Amsterdam (NL)
- Corresponding author
- Prins, Maria
- Geijtenbeek, Teunis BH
- Venue
- Journal of the International AIDS Society
- Publisher
- Wiley
- Published
- 2019-08
- Volume
- 22
- Issue
- S6
- Pages
- e25348-e25348
- ISSN
- 1758-2652 (ISSN-L)
- PMC
- PMC6715947
- OpenAlex
- W2970998293
- Cited by
- 100
- References
- 128
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 18 · 2023: 13 · 2022: 19 · 2021: 13 · 2020: 15 · 2019: 6
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the International AIDS Society (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw (522004008)
- H2020 European Research Council (670424)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- hepatitis C virus, sexual transmission, men who have sex with men, HIV-1 coinfection, HCV reinfection, people who inject drugs, dendritic cells, HCV prevention, pre-exposure prophylaxis, sexually transmitted infections
- MeSH terms
- Sexual and Gender Minorities, Hepatitis C, Humans, Male, Sexually Transmitted Diseases, HIV-1, HIV Infections, Hepacivirus, Hepatitis C Antibodies, Coinfection
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