MSM without HIV remain at risk for HCV

Issue: July 2015

HIV-negative men who have sex with men are still at risk for contracting hepatitis C virus infection, according to findings published in the Journal of Viral Hepatitis.

“HIV-negative MSM have lower observed rates of HCV infection compared with HIV-infected MSM,” the researchers wrote. “We sought to identify the prevalence of acute hepatitis C in this population.”

Researchers performed a retrospective review of HCV testing in HIV-negative MSM attending a large urban sexual health service between January 2010 and May 2014. Data were analyzed to determine any risk for HCV in MSM who were HIV-negative. Forty-four men who satisfied criteria for acute hepatitis C were included in the final analysis. The median age was 37 years.

Of the men included, 10 were RNA negative at baseline and classed as prior spontaneous clearance, 15 men (34.1%) were previously negative for HCV antibody within 1 year, 11 men (25%) had significant elevation in alanine aminotransferase levels, and 18 (40.9%) were clinically diagnosed from risk exposure and history, according to the research.

Overall, 93.2% of men (n = 41) reported engaging in unprotected anal sex, 87.8% reported engaging in insertive and receptive intercourse (n = 36), 9.8% engaged in receptive intercourse (n = 4), 2.4% engaged in insertive intercourse (n = 1), and no data were available for 7.3% of men (n = 3).

The men had an average of 7.3 reported partners. Twelve of the men (27.3%) reported engaging in group sex; 11 practiced fisting (25%); 11 reported using drugs during sexual activity (25%); 16 reported nasal (36.4%); and 9 reported injection drug use (20.5%), the researchers said.

Approximately 31.8% of the men had unprotected sex under the influence of recreational drugs. Twenty-nine of the men reported knowing a partner’s status, two men had sexual contact with a known HCV-monoinfected partner (4.5%), 13 engaged in sexual intercourse with an HIV monoinfected partner (29.5%) and 6 had sexual intercourse with a HCV/HIV coinfected partner (13.6%).

Nine men reported a partner or partners with no known infection (20.5%), and there was no data available in 14 of the men in the cohort (31.8%). Fifteen men (34.1%) achieved spontaneous clearance of HCV, while 11 underwent HCV therapy.

“HIV-negative MSM remain at risk of HCV infection, sharing similar risk behaviors as HIV-positive MSM,” the researchers concluded. “HCV testing should be part of routine sexual health screening in those with risk factors, particularly in environments with a high HCV prevalence.” – by Melinda Stevens

Reference:
McFaul K, et al. J Viral Hepat. 2015;doi:10.1111/jvh.12366.

Disclosure: The researchers report no relevant financial disclosures.