Patterns of Hepatitis C Virus Transmission in Human Immunodeficiency Virus (HIV)–infected and HIV-negative Men Who Have Sex With Men. (27th February 2019)

• Record Type: Journal Article
• Authors: Ramière, Christophe; Charre, Caroline; Miailhes, Patrick; Bailly, François; Radenne, Sylvie; Uhres, Anne-Claire; Brochier, Corinne; Godinot, Matthieu; Chiarello, Pierre; Pradat, Pierre; Cotte, Laurent
• Is Part Of: Clinical infectious diseases. Volume 69:Number 12(2019)
• Page Start: 2127
• Page End: 2135
• Publication Date: 2019-02-27
• Subjects: HCV -- acute infection -- MSM -- cluster -- transmission; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz160
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Sexually transmitted acute hepatitis C virus (HCV) infections (AHIs) have been mainly described in human immunodeficiency virus (HIV)–infected men who have sex with men (MSM). Cases in HIV-negative MSM are scarce. We describe the epidemic of AHI in HIV-infected and HIV-negative MSM in Lyon, France. Methods: All cases of AHI diagnosed in MSM in Lyon University Hospital from 2014 to 2017 were included. AHI incidence was determined in HIV-infected and in preexposure prophylaxis (PrEP)–using MSM. Transmission clusters were identified by construction of phylogenetic trees based on HCV NS5B (genotype 1a/4d) or NS5A (genotype 3a) Sanger sequencing. Results: From 2014 to 2017, 108 AHIs (80 first infections, 28 reinfections) were reported in 96 MSM (HIV-infected, 72; HIV-negative, 24). AHI incidence rose from 1.1/100 person-years (95 confidence interval [CI], 0.7–1.7) in 2014 to 2.4/100 person-years (95 CI, 1.1–2.6) in 2017 in HIV-infected MSM ( P = .05) and from 0.3/100 person-years (95 CI, 0.06–1.0) in 2016 to 3.4/100 person-years (95 CI, 2.0–5.5) in 2017 in PrEP users ( P < .001). Eleven clusters were identified. All clusters included HIV-infected MSM; 6 also included HIV-negative MSM. All clusters started with ≥1 HIV-infected MSM. Risk factor distribution varied among clusters. Conclusions: AHI incidence increased in both HIV-infected and HIV-negative MSM. Cluster analysis suggests initial transmission from HIV-infected to HIV-negative MSM through chemsex and traumatic sexual practices, leading to mixed patterns of transmission regardless of HIV status and no overlap with the general population. Abstract : An epidemic of acute hepatitis C virus infections in men who have sex with men (MSM) between 2014 and 2017 in Lyon, France, is reported. Ninety-six percent of cases belonged to clusters. Half the clusters included both human immunodeficiency virus (HIV)–infected and HIV-negative MSM. Risk factors varied widely among clusters.