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Viral hepatitis update: 6 reports for men who have sex with men

The CDC released an educational web feature and other educational resources for Pride Month designed to increase the awareness of hepatitis A outbreaks among men who have sex with men that have occurred both in the United States as well as internationally. The resources also provide information about hepatitis vaccinations.

Healio Gastroenterology and Liver Disease presents the following reports on increased rates of HAV outbreaks among MSM and reports on acute hepatitis C rates among MSM regarding how rates have decreased in some populations with HIV coinfections but increased in younger patients.

Acute HCV decreasing in men who have sex with men with HIV

The rates of hepatitis C incidence among men who have sex with men with HIV has significantly decreased in London since the epidemic peak in 2015, coinciding with wider access to direct-acting antiviral therapy, according to data presented at CROI.

“The WHO aims to reduce by 90% the number of new infections of the next decade. Micro-elimination of well-defined populations has been suggested as an initial approach and, in the U.K., the British HIV Association ambitiously aims to cure all hepatitis C coinfection by 2021,” Lucy J. Garvey, MD(Res), MRCP, from the Imperial College Healthcare NHS Trust in London, said during her presentation. “If we consider the HIV-positive MSM population as a potential for micro-elimination, modeling work has predicted that significant scale-up of treatment including access for recent infection plus risk reduction work will all be important if these reductions in incidence are to be achieved.” Read more

Hepatitis A outbreaks nearly 300% higher in recent years

Reports of hepatitis A infections increased by nearly 300% in the U.S. between 2016 and 2018 compared with 2013 to 2015, primarily due to outbreaks associated with contaminated food items, men who have sex with men, and people who report drug use or homelessness, according to the CDC.

Monique A. Foster, MD, and colleagues from the National Center for HIV, Viral Hepatitis, STD, and TB Prevention at the CDC, wrote that hepatitis A outbreaks previously occurred every 10 to 15 years and were associated with asymptomatic children. Read more

HCV reinfection remains high in MSM with HIV regardless of treatment

Long-term surveillance among men who have sex with men with HIV after clearance of hepatitis C may be warranted as reinfection rates remain high and continue to occur more than 11 years after clearance regardless of treatment, according to a study presented at CROI.

“This high reinfection rate in New York tells us that we have not done a good job of treating all our HIV-infected patients with hepatitis C despite the availability in NYC of direct-acting antivirals since 2013,” Daniel S. Fierer, MD, from the Icahn School of Medicine at Mount Sinai in New York, said during his presentation. Read more

International HCV transmission in European MSM requires DAA scale-up

In Switzerland, men who have sex with men from other countries likely account for about one-quarter of acute hepatitis C infections, according to a study presented at the Conference on Retroviruses and Opportunistic Infections, also known as CROI. The researchers recommend joint European scale-up schemes for DAA therapy.

“Scale-up of direct-acting antivirals, or DAA therapy, is happening all over Europe and independently in several countries, but Europe is highly interconnected and hepatitis C transmission knows no borders,” Luisa Salazar-Vizcaya, PhD, from the University Hospital of Bern, Switzerland, said in her presentation. “Mathematical models suggest that scale-up of DAAs has the potential to curve the epidemic of hepatitis C among HIV-positive MSM.” Read more

Hepatitis A increase in NYC linked to travel among MSM

According to the CDC, the New York City Department of Health and Mental Hygiene reported an increase in hepatitis A infection among men who have sex with men in the city this year. Further, some of these men report traveling to areas in Western Europe where HAV outbreaks are ongoing among MSM.

Between Jan. 1, and Aug. 31, 2017, the Department of Health and Mental Hygiene (DOHMH) identified 51 patients with HAV linked to the increase in New York City and with a history of sexual contact with MSM. Read more

HCV rates climbing in younger HIV-positive MSM

Hepatitis C infection rates continue to increase in Northern Europe in recent years among younger men who have HIV and have sex with men, with those more recently infected with HIV showing higher rates of HCV infection, according to a recently published article.

“No decline in HCV incidence was observed in recent years, although trends seem to differ by geographical region,” the researchers wrote. “HCV screening among HIV-positive MSM should be continued and routinely and frequently offered. Furthermore, targeted preventive measures should be implemented and/or scaled-up to decrease the risk of HCV acquisition.” Read more