Sexual risk behavior influences HCV reinfection incidence among HIV-positive MSM
High rates of hepatitis C virus reinfection strongly correlated with risky sexual behavior among men who have sex with men who are HIV-positive, according to data published in Clinical Infectious Diseases.
“The incidence of HCV reinfection among HIV-positive MSM is very high,” Astrid M. Newsum, of the department of infectious diseases, research and prevention at the Public Health Service of Amsterdam and the division of infectious diseases at Amsterdam University Medical Center, told Healio. “The risk factors for a primary HCV infection are well studied, but factors associated with HCV reinfection among HIV-positive MSM have never been comprehensively assessed.”
Newsum and colleagues used data from a prospective observational cohort study of HIV-positive MSM with acute HCV infection to determine the incidence of HCV reinfection after spontaneous clearance or successful treatment. The researchers also identified risk factors associated with HCV reinfection.
The study included 122 HIV-positive MSM with HCV infection that spontaneously cleared or was successfully treated between 2003 and 2017. Most participants (n = 110) began follow-up after their first HCV infection; the remaining participants (n = 12) did so after their second infection.
Over a median follow-up of 1.4 years, 34 HCV reinfections occurred among 28 patients. the incidence of HCV reinfection was 11.5 per 100 person-years. The median time to reinfection was 1.3 years.
Reinfection was correlated with receptive condomless anal intercourse, sharing of sex toys, group sex, anal rinsing before sex and having 10 or more casual sex partners in the last 6 months, as well as a low CD4 count.
“The findings of our study highlight the need for effective interventions aimed at reducing risk behavior and preventing reinfection among HIV-positive MSM,” Newsum said. “The risk factors found in this study could aid development of such interventions and could help clinicians identify patients at high risk for HCV reinfection who should be frequently monitored with HCV RNA testing.”