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Activation of Hepatic Stellate Cells Drives the Rapid Development of
Liver Fibrosis During Acute HCV Infection in HIV-infected Men
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Reported by Jules Levin
AASLD 2015 Nov 13-17 San Francisco
Gillies R, Fierer DS, Yip MJ-S,
Friedman S, Branch AD, Dieterich DT, and Fiel MI
[from Jules: research over past many years in NYC by Fierer has found that HCV transmission in HIV+ MSM may progress rapidly....MACS reports HCV spread among both HIV+ & uninfected MSM in the US has been ongoing for decades....HCV screening every 6-12 months & ALT testing every 3 months is recommended]
AASLD: Rectal Shedding of HCV in HIV/HCV co-infected Men - (11/16/15)
a subgroup of HIV-positive MSM with recurring sexual exposure to HCV in whom the rates may begin to approach the risk of HCV infection among PWID......http://www.natap.org/2015/HCV/091415_11.htm......Reinfection postsuccessful HCV treatment (n = 2 studies) was 20 times higher than initial seroconversion rates
Rapid Progression to Decompensated Cirrhosis, Liver Transplantation, and Death in HIV-infected Men after Primary HCV Infection......http://www.natap.org/2013/HCV/010413_06.htm......." four HIV-infected men who progressed from primary HCV infection to decompensated cirrhosis far more rapidly than expected"
"New York State Department of Health AIDS Institute recommends annual HCV antibody testing for HIV-infected patients who have continued high-risk drug and/or sexual behaviors but are seronegative for HCV"...men with ≥3 URAI partners during the prior 6 months were more likely than those with 2 URAI partners to become HCV infected (IR, 9.03 and 5.34 per 1000 PYs), although these IRs were not significantly different (P = .14)........HIV infection led to a 6- to 8-fold higher incidence of HCV. A study of women also found that HIV infection increased the risk for HCV infection, and there was also a trend toward an increased risk with CD4 count <200 cells/mm.....http://www.natap.org/2015/HCV/071015_01.htm
Acute HCV infection of HIV-infected MSM in New York City is sexually transmitted and results in significant liver fibrosis.......We therefore recommend ALT testing every 3 months and HCV antibody testing every 6-12 months for all HIV-infected MSM. Promotion of safe sex is also warranted. ......http://www.natap.org/2009/AASLD/AASLD_15.htm
The spread of HCV among both HIV-infected and -uninfected MSM in the United States has been ongoing since the beginning of the HIV epidemic.......The only sexual behavior that was significantly associated with an increased HCV incidence was having URAI during the prior 6 months with multiple partners either as both the insertive and receptive partner (IR, 6.31/1000 PYs, P < .001) or as the receptive partner only (IR, 9.67/1000 PYs, P < .001)...... men with ≥3 URAI partners during the prior 6 months were more likely than those with 2 URAI partners to become HCV infected (IR, 9.03 and 5.34 per 1000 PYs), although these IRs were not significantly different (P = .14)...... [http://www.natap.org/2013/HCV/092013_01.htm]"
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