Scaling up epidemics of acute hepatitis C and syphilis in HIV‐infected men who have sex with men in Spain. (3rd June 2013)

• Record Type: Journal Article
• Authors: Sánchez, Clara; Plaza, Zulema; Vispo, Eugenia; de, Carmen; Barreiro, Pablo; Fernández‐Montero, José V.; Labarga, Pablo; Poveda, Eva; Soriano, Vincent
• Is Part Of: Liver international. Volume 33:Number 9(2013:Oct.)
• Page Start: 1357
• Page End: 1362
• Publication Date: 2013-06-03
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12212
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12212-abs-0001"> <title>Abstract</title> <sec id="liv12212-sec-0001" sec-type="section"> <title>Background</title> <p>Outbreaks of acute hepatitis C in HIV‐positive men who have sex with men (MSM) are being reported in large cities in western countries along with increasing rates of sexually transmitted diseases.</p> </sec> <sec id="liv12212-sec-0002" sec-type="section"> <title>Methods</title> <p>All HIV individuals attended at a large outclinic in Madrid within the last 5 years were examined. Incident syphilis was diagnosed based on rapid plasma reagin (RPR) reactivity, being negative previously or showing >4‐fold increase. Acute hepatitis C was diagnosed based on HCV antibody seroconversion and/or positive serum HCV‐RNA after being negative within the last year.</p> </sec> <sec id="liv12212-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 859 episodes of syphilis and 19 of acute hepatitis C were diagnosed during the study period. Syphilis was recognized in 65/2, 094 (3.1%) individuals attended in 2008 and rose up to 261/2, 512 (10.4%) in 2012 (<italic>P</italic> < 0.001). Acute hepatitis C was diagnosed in only one subject in 2008 but rose up to 7 in 2012 (<italic>P</italic> = 0.12).</p> <p>All 19 HIV patients with acute hepatitis C were MSM. Syphilis was diagnosed concomitantly in seven. All eight individuals who were treated with peginterferon/ribavirin were cured, whereas only one untreated experienced spontaneous clearance (<italic>P</italic> = 0.004). Two clusters of infections by HCV genotypes 4 and 1a were identified by phylogenetic analyses.</p> </sec> <sec id="liv12212-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The incidence of acute hepatitis C is low but steadily increasing in HIV‐positive MSM in Madrid (<1% yearly), despite the very high rates of syphilis (currently 20% yearly in HIV‐positive MSM). Preventive measures for sexually transmitted infections and periodic HCV screening are warranted in this population as treatment of acute hepatitis C is very effective.</p> </sec> </abstract>