Early Evidence of HCV epidemic in US HIV-infected MSM

[Guest guest]

http://www.hivandhepatitis.com/cme/2011/healthmatters/pos_croi2011/doc/PositiveP\

ulseNewsletter_Final.pdf

Early Evidence of HCV epidemic in US HIV-infected MSM

Analyzing hepatitis C virus (HCV) sequences from 93 patients in 5 US cities,

researchers found evidence of extensive clustering of HCV infections among

HIV-infected men who have sex with men (MSM), suggesting that acquisition is

related more to high-risk activities or increased susceptibility than to the

presence of more transmissible HCV. All of the HCV viruses identified were

genotype 1: 83 (89%) were genotype 1a and 10 (11%) were genotype 1b. Researchers

identified 9 clusters composed of 3 to 10 HCV genotype 1a patients each, with 52

(56%) of all patients in these clusters. In addition, there were 6 pairs (2-man

clusters) of homologous sequences (10 genotype 1a, 2 genotype 1b); 12 (13%) of

all patients were in these MSM-related pairs. Thus, a total of 69% of the MSM in

the United States harbored an HCV sequence that was very similar to a sequence

found in at least 1 other MSM patient, usually from the same city. Despite

similar epidemics among MSM in Europe and Australia, there was limited genetic

overlap between the viral isolates identified in the United States and Europe.

This finding suggests that the epidemic of HCV infections is occurring de novo

in cities with large populations of MSM.

Editors’ Commentary

Dr Sax: It has been known for some time that a substantial proportion of

incident cases of HCV among HIV-infected MSM is sexually transmitted. Among

HIV/HCV-coinfected heterosexuals, injection drug use remains the dominant risk

factor. Data such as those presented here suggest that clinicians should

consider periodic screening for HCV among their HIV-infected MSM patients.

Dr Sulkowski: At this point, there is incontrovertible evidence that HCV is an

STI among HIV-infected MSM. This observation has important implications for

messages regarding the use of condoms as well as annual screening with HCV

antibody for HIV-infected men who are seronegative. In addition, the

identification of acute HCV in HIV-infected MSM should prompt strong

consideration of HCV treatment because this approach is highly effective in

eradication of the infection and preventing the progression to chronic

infection.

[Guest guest]

http://www.hivandhepatitis.com/cme/2011/healthmatters/pos_croi2011/doc/PositiveP\

ulseNewsletter_Final.pdf

Early Evidence of HCV epidemic in US HIV-infected MSM

Analyzing hepatitis C virus (HCV) sequences from 93 patients in 5 US cities,

researchers found evidence of extensive clustering of HCV infections among

HIV-infected men who have sex with men (MSM), suggesting that acquisition is

related more to high-risk activities or increased susceptibility than to the

presence of more transmissible HCV. All of the HCV viruses identified were

genotype 1: 83 (89%) were genotype 1a and 10 (11%) were genotype 1b. Researchers

identified 9 clusters composed of 3 to 10 HCV genotype 1a patients each, with 52

(56%) of all patients in these clusters. In addition, there were 6 pairs (2-man

clusters) of homologous sequences (10 genotype 1a, 2 genotype 1b); 12 (13%) of

all patients were in these MSM-related pairs. Thus, a total of 69% of the MSM in

the United States harbored an HCV sequence that was very similar to a sequence

found in at least 1 other MSM patient, usually from the same city. Despite

similar epidemics among MSM in Europe and Australia, there was limited genetic

overlap between the viral isolates identified in the United States and Europe.

This finding suggests that the epidemic of HCV infections is occurring de novo

in cities with large populations of MSM.

Editors’ Commentary

Dr Sax: It has been known for some time that a substantial proportion of

incident cases of HCV among HIV-infected MSM is sexually transmitted. Among

HIV/HCV-coinfected heterosexuals, injection drug use remains the dominant risk

factor. Data such as those presented here suggest that clinicians should

consider periodic screening for HCV among their HIV-infected MSM patients.

Dr Sulkowski: At this point, there is incontrovertible evidence that HCV is an

STI among HIV-infected MSM. This observation has important implications for

messages regarding the use of condoms as well as annual screening with HCV

antibody for HIV-infected men who are seronegative. In addition, the

identification of acute HCV in HIV-infected MSM should prompt strong

consideration of HCV treatment because this approach is highly effective in

eradication of the infection and preventing the progression to chronic

infection.

[Guest guest]

http://www.hivandhepatitis.com/cme/2011/healthmatters/pos_croi2011/doc/PositiveP\

ulseNewsletter_Final.pdf

Early Evidence of HCV epidemic in US HIV-infected MSM

Analyzing hepatitis C virus (HCV) sequences from 93 patients in 5 US cities,

researchers found evidence of extensive clustering of HCV infections among

HIV-infected men who have sex with men (MSM), suggesting that acquisition is

related more to high-risk activities or increased susceptibility than to the

presence of more transmissible HCV. All of the HCV viruses identified were

genotype 1: 83 (89%) were genotype 1a and 10 (11%) were genotype 1b. Researchers

identified 9 clusters composed of 3 to 10 HCV genotype 1a patients each, with 52

(56%) of all patients in these clusters. In addition, there were 6 pairs (2-man

clusters) of homologous sequences (10 genotype 1a, 2 genotype 1b); 12 (13%) of

all patients were in these MSM-related pairs. Thus, a total of 69% of the MSM in

the United States harbored an HCV sequence that was very similar to a sequence

found in at least 1 other MSM patient, usually from the same city. Despite

similar epidemics among MSM in Europe and Australia, there was limited genetic

overlap between the viral isolates identified in the United States and Europe.

This finding suggests that the epidemic of HCV infections is occurring de novo

in cities with large populations of MSM.

Editors’ Commentary

Dr Sax: It has been known for some time that a substantial proportion of

incident cases of HCV among HIV-infected MSM is sexually transmitted. Among

HIV/HCV-coinfected heterosexuals, injection drug use remains the dominant risk

factor. Data such as those presented here suggest that clinicians should

consider periodic screening for HCV among their HIV-infected MSM patients.

Dr Sulkowski: At this point, there is incontrovertible evidence that HCV is an

STI among HIV-infected MSM. This observation has important implications for

messages regarding the use of condoms as well as annual screening with HCV

antibody for HIV-infected men who are seronegative. In addition, the

identification of acute HCV in HIV-infected MSM should prompt strong

consideration of HCV treatment because this approach is highly effective in

eradication of the infection and preventing the progression to chronic

infection.

[Guest guest]

http://www.hivandhepatitis.com/cme/2011/healthmatters/pos_croi2011/doc/PositiveP\

ulseNewsletter_Final.pdf

Early Evidence of HCV epidemic in US HIV-infected MSM

Analyzing hepatitis C virus (HCV) sequences from 93 patients in 5 US cities,

researchers found evidence of extensive clustering of HCV infections among

HIV-infected men who have sex with men (MSM), suggesting that acquisition is

related more to high-risk activities or increased susceptibility than to the

presence of more transmissible HCV. All of the HCV viruses identified were

genotype 1: 83 (89%) were genotype 1a and 10 (11%) were genotype 1b. Researchers

identified 9 clusters composed of 3 to 10 HCV genotype 1a patients each, with 52

(56%) of all patients in these clusters. In addition, there were 6 pairs (2-man

clusters) of homologous sequences (10 genotype 1a, 2 genotype 1b); 12 (13%) of

all patients were in these MSM-related pairs. Thus, a total of 69% of the MSM in

the United States harbored an HCV sequence that was very similar to a sequence

found in at least 1 other MSM patient, usually from the same city. Despite

similar epidemics among MSM in Europe and Australia, there was limited genetic

overlap between the viral isolates identified in the United States and Europe.

This finding suggests that the epidemic of HCV infections is occurring de novo

in cities with large populations of MSM.

Editors’ Commentary

Dr Sax: It has been known for some time that a substantial proportion of

incident cases of HCV among HIV-infected MSM is sexually transmitted. Among

HIV/HCV-coinfected heterosexuals, injection drug use remains the dominant risk

factor. Data such as those presented here suggest that clinicians should

consider periodic screening for HCV among their HIV-infected MSM patients.

Dr Sulkowski: At this point, there is incontrovertible evidence that HCV is an

STI among HIV-infected MSM. This observation has important implications for

messages regarding the use of condoms as well as annual screening with HCV

antibody for HIV-infected men who are seronegative. In addition, the

identification of acute HCV in HIV-infected MSM should prompt strong

consideration of HCV treatment because this approach is highly effective in

eradication of the infection and preventing the progression to chronic

infection.