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High incidence of HCV (re-)infections among PrEP users in the Netherlands: implications for prevention, monitoring and treatment
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Reported by Jules Levin
22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018
HCV SEx Transmsision MSM & MSM HIV+ NOT NEW RISK. Risk on PrEP NOT NEW EITHER: This HCV risk through sexual transmission or through sharing needles on PrEP is nothing new, its been ongoing for years since PrEP was approve. And the reinfection of HCV after successful treatment IS NOT NEW EITHER. IN THIS STUDY transmission is likely sexual transmission, which again is NOT NEW. FOR YEARS NOW HCV sexual transmission has been repeatedly reported in major European cities where MSM travel to and participate in sex parties, which is where thee men in this study may have contracted HCV. They may be taking PrEP but they obviously putting themselves at risk for HCV despite HIV protection with PrEP, suggesting unsafe sexual behavior. This was ongoing in NYC for several years, but the discussion about this has ceased.
THIS GOES BACK to 1995 in the USA among men & women: HCV Sexual Transmission - 2 studies below from 1995 at Johns Hopkins STD Clinics finding HCV sex transmission among non-IDU men & women, mostly African-Americans, & in Netherlands among HIV+ MSM; and links below to studies from 2002/2003/2006 reporting the same, particularly sex transmission to non-IDU heterosexual HIV+ women.....Early Reports [2006] of Sexual HCV Transmission in HIV+ MSM, HIV+ Non-IDU Women, and HCV Sexual Transmission at Johns Hopkins STD Clinics in Baltimore Reported in 1995 Publication where they reported: "Anti-HCV was detected in 7% and 4% of non-injection drug-using males and females. respectively......Females with anti-HCV-positive sex partners were 3.7 times more likely to have anti-HCV than females with anti-HCV-negative sex partners
In NYC reported at this CROI was low prevalence of HCV transmission on PrEP at t NYC sexual health clinics, but this may not represent other MSM on PrEP in NYC, perhaps these clinics counsel clients properly & they take advice or the data is wrong. I have doubts that in NYC MSM on PrEP have low prevalence of HCV sexual transmission.
Low Prevalence of Hepatitis C Virus Among New York City MSM Initiating PrEP and PEP, 2016-2017 at NYC Sexual Health Clinics
This study was published way back in 2009 reporting on this epidemic of HCV sexual transmission among HIV+ MSM - Evidence of a large, International Network of HCV Transmission in HIV-Positive Men Who Have Sex With Men - "an increasing number of hepatitis C virus (HCV) outbreaks have been reported among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) in large urban centers in Europe..."
And in nYC this study from 2015 reported the same - Incidence of sexually transmitted hepatitis C virus infection in HIV-positive MSM: a systematic review and meta-analysis -
HCV in MSM High-Risk Groups - need for targeted hepatitis C prevention and testing campaigns for this group
"These data indicate that there exists 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......HCV seroconversion reported on associations with potentially causal exposures (sexual risk behavior...in the New York City case-control study [48], the adjusted odds ratio (AOR) for receptive anal intercourse without a condom, with ejaculation was 23.0 (95% CI 2.2-243.8) and the proportion of HCV infections in the cases that were attributable to this behaviour was 95.7%."
Elske Hoornenborg, MD
GGD Amsterdam
AIDS 2018, Amsterdam, the Netherlands
"We suggest routine HCV testing of MSM on PrEP, prompt referral and treatment for those who test positive, and the use of prevention interventions if one not infected with HCV."
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