Alarming incidence of hepatitis C virus (HCV) reinfection after treatment of sexually acquired acute HCV infection in HIV-infected men having sex with men in Amsterdam.

Published: August 19, 2011

Abstract
BACKGROUND:

Recent data indicate that the seroprevalence of sexually transmitted hepatitis C virus (HCV) infection among men having sex with men (MSM) is stabilizing in Amsterdam. However, little is known about the incidence of HCV reinfection in MSM who have cleared their HCV infection. We therefore studied the incidence of reinfection in HIV-infected MSM who were HCV RNA-negative following HCV treatment of acute primary infection.
METHODS:

Our study population comprised HIV-infected MSM at two large HIV outpatient clinics in Amsterdam who were previously diagnosed with a sexually transmitted acute HCV infection and tested HCV RNA-negative at the end of treatment. We defined HCV reinfection as detectable HCV RNA in subjects with an undetectable HCV RNA at the end of treatment accompanied by a switch in HCV genotype or clade. Person-time methods were used to calculate the incidence of reinfection.
RESULTS:

Fifty-six persons who became HCV RNA-negative during primary acute HCV treatment were included. Five of the 56 cases relapsed and were not analysed. Eleven persons were reinfected. The incidence of HCV reinfection in this group was 15.2 per 100 person-years (95% confidence interval [CI], 8.0-26.5). The cumulative incidence was 33% within 2 years.
DISCUSSION:

An alarmingly high incidence of HCV reinfection was found in this group. This high reinfection rate indicates that current prevention measures should be discussed, frequent HCV RNA testing should be continued after successful treatment and in case of possible relapse, clade typing should be performed to exclude reinfection.

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