HCV Re-Infection Rate High Among PrEP-Using MSM

According to results of a study presented at AIDS 2018, the hepatitis C virus (HCV) re-infection rate is high among MSM who were taking pre-exposure prophylaxis (PrEP).

AIDS 2018 is hosted in Amsterdam, the Netherlands, from July 23 to 27 and features prominent researchers from around the world.

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To conduct their study, the researchers examined the HCV incidence rate, characteristics of newly infected individuals, HCV genotype distribution, and phylogenetic clustering among MSM (n = 374) and transgender persons (n = 2) who were using PrEP in the Amsterdam PrEP project at the Public Health Service of Amsterdam.

Participants were tested twice per year for HCV antibodies and HCV RNA antibodies, if they were present.

Over the 2-year study period, 6 primary infections and 6 re-infections were diagnosed, all in MSM.

The incidence rate was 1.9 per 100 person years; the incidence rate of primary infection was 1.0 per 100 person years; and the incidence rate of re-infection was 25.5 per 100 person years.

Findings from the phylogenetic analysis showed that 8 out of 9 HCV-1a infections were part of 4 large MSM-specific HCV-1a clusters that included MSM with and without HIV. (See the phylogenetic tree in the researchers’ abstract here.)

“In the Netherlands, incidence of initial and re-HCV infection among HIV-negative MSM on PrEP was high and comparable to that observed in HIV-positive MSM,” the researchers concluded. “The high degree of phylogenetic clustering between HCV strains acquired by MSM with and without HIV suggests a shared transmission network. Regular HCV testing to provide prompt treatment as well [as] interventions to lower HCV-related behavior should be offered to MSM on PrEP.”

—Amanda Balbi

Reference:

Hoornenborg E, Coyer LN, Achterbergh RCA, et al; the Amsterdam PrEP Project Team in the HIV Transmission Elimination AMsterdam Initiative (H-TEAM). High incidence of hepatitis C virus (re-)infections among PrEP users in the Netherlands: Implications for prevention, monitoring and treatment. Paper presented at: AIDS 2018; July 23-27, 2018; Amsterdam, the Netherlands. http://programme.aids2018.org/Abstract/Abstract/2682. Accessed July 24, 2018.

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