HCV reinfection incidence and spontaneous clearance rates in HIV-positive men who have sex with men in Western Europe.
Open accessAbstract
Background & aims Moderate cure rates of acute hepatitis C virus (HCV) infections with pegylated interferon and ribavirin have been described in the last decade in men who have sex with men (MSM), who are also coinfected with the human immunodeficiency virus (HIV). However, a subsequent high incidence of HCV reinfections has been reported regionally in men who both clear the infection spontaneously or who respond to treatment.Methods Retrospective analysis of reinfections in HIV infected MSM in eight centers from Austria, France, Germany, and the UK within the NEAT network between May 2002 and June 2014.Results Of 606 individuals who cleared HCV spontaneously or were successfully treated, 149 (24.6%) presented with a subsequent HCV reinfection. Thirty out of 70 (43%) who cleared again or were successfully treated, presented with a second reinfection, 5 with a third, and one with a fourth reinfection. The reinfection incidence was 7.3/100 person-years (95% CI 6.2-8.6). We found a trend for lower incidence among individuals who had spontaneously cleared their incident infection than among individuals who were treated (Hazard ratio 0.62, 95% CI 0.38-1.02, p=0.06). Spontaneous clearance of reinfection was associated with ALT levels >1000IU/ml and spontaneous clearance of a prior infection.Conclusions HCV reinfection is an issue of major concern in HIV-positive MSM. Prevention strategies are needed for high risk groups to reduce morbidity and treatment costs. HIV-positive MSM with a prior HCV infection should be tested every 3 to 6months for reinfection. Those who had achieved a reinfection should be tested every 3months.Lay summary We evaluated the occurrence of HCV reinfection in HIV-positive men who have sex with men. We found an alarming incidence of 7.3/100 person-years. Prevention measures need to address this specific subgroup of patients at high risk for HCV.
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Regular screening of persons with HIV for HCV is cost-effective.
“Because acute HCV infection acquisition among persons with HIV infection can occur, especially among MSM, and regular screening of those with HIV is cost-effective (238,239,1377), periodic HCV screening should be conducted (1378–1380).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1380]
The Discussion recommends frequent HCV RNA testing for HIV-positive MSM after an HCV infection, but does not assess whether screening is cost-effective. A search for cost-effectiveness and economic evaluation found no passage supporting that claim. (LLM, conf=0.76)
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Self-citation
- Authors
- Ingiliz, P., Martin, T. C., Rodger, A., Stellbrink, H.-J., Mauss, S., Boesecke, C., Mandorfer, M., Bottero, J., Baumgarten, A., Bhagani, S., Lacombe, K., Nelson, M., & Rockstroh, J. K.
- Affiliations
- Chelsea and Westminster Hospital (GB)
- The Royal Free Hospital (GB)
- Infektionsmedizinisches Centrum Hamburg (DE)
- Center for HIV and Hepatogastroenterology (DE)
- University of Bonn (DE)
- Medical University of Vienna (AT)
- Assistance Publique – Hôpitaux de Paris (FR)
- Inserm (FR)
- Corresponding author
- Ingiliz, Patrick
- ORCID
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 66
- Issue
- 2
- Pages
- 282-287
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2520350813
- Cited by
- 173
- References
- 39
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 11 · 2023: 10 · 2022: 19 · 2021: 14 · 2020: 19 · 2019: 35 · 2018: 30 · 2017: 18 · 2016: 4 · 2015: 1
- FWCI
- 20.96
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by-nc-nd)
- HAL (submittedVersion)
- Funders
- NEAT (LSHP-CT-2006-037570)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Keywords
- HIV/HCV coinfection, men who have sex with men, spontaneous HCV clearance, ALT levels
- MeSH terms
- Adult, Antiviral Agents, Communicable Disease Control, Europe, Female, Hepatitis C, HIV Seropositivity, Humans, Male, Middle Aged, HIV Infections, Incidence, Hepacivirus, Homosexuality, Male, Coinfection
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