HIV-Positive Men Who Bareback Should Have More Frequent Hep C Testing

Published: February 4, 2011

A new study has found that 75 percent of new hepatitis C virus (HCV) infections in HIV-positive men occurred in those with no history of injection drug use (IDU), mirroring other studies documenting a rise in cases of HCV infection in men who have sex with men (MSM) in Western Europe, Australia and urban cities in the United States. The study, published online January 31 in the journal Clinical Infectious Diseases, prompted the researchers to echo the conclusion of other cohort findings by recommending more frequent testing for HCV antibodies in those with high-risk practices, such as MSM who practice anal sex without condoms.

Because of shared transmission routes, up to 30 percent of people with HIV in the United States also have chronic HCV infection. Chronic liver disease is a leading cause of death in people with HIV, and people coinfected with both HIV and HCV are also at a higher risk of death from a number of non-liver-related diseases, including kidney disease.

The majority of HCV cases in the United States are attributable to injection drug use, but there have been reports of HCV transmission in MSM who have no IDU history. Studies of these cases have suggested that HCV risk in these individuals is associated with various sexual practices, including unprotected anal intercourse, the use of sex toys, multiple partners and fisting.

To further explore the occurrence of HCV infection in people already infected with HIV, Lynn Taylor, MD, of Brown University in Providence, Rhode Island, and her colleagues examined data from the 4,000-plus-person ALLRT study.

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