title: Acute hepatitis C infection in HIV positive men who have sex with men in Paris, France, 2001-2004.
abstract: In mid-2004, three Parisian hospital wards informed the Institut de veille sanitaire of recent acute hepatitis C in HIV-infected (HIV+) men who had sex with men (MSM). These cases for whom none of the usual bloodborne routes for hepatitis C (HCV) transmission was found, reported having had unprotected sex. In October 2004, we conducted a retrospective investigation in Parisian hospital wards to explore HCV modes of transmission in recent acute hepatitis C in HIV+ MSM. Patient demographics, clinical and biological status of HIV infection, reasons for HCV testing, sexual behaviour and risk factors for HCV transmission within the 6 months before hepatitis onset were collected from medical records. An anonymous self-administered questionnaire on sexual behaviour within the six months before hepatitis onset was also offered to all cases. We identified 29 cases of acute hepatitis C in HIV+ MSM with onset from April 2001 to October 2004. HIV infection was asymptomatic for 76%. Median age at hepatitis C onset was 40 (28-54) years. In all records, were noted unprotected anal sex, fisting in 21% and a concomitant sexually transmitted infection (STI) in 41%. Median time between HIV diagnosis and HCV infection was 6.5 years (0-22). From the 11 self-administered questionnaires completed, 10 reported an STI, 8 'hard' sexual practices, 6 bleeding during sex and 5 fisting. HCV transmission probably occurred through bleeding during unprotected traumatic anal sex among HIV+ MSM and may be facilitated by STI mucosal lesions. This report stresses the continuous need to strongly advocate safer sex to MSM.
authors.affiliation: Institut de veille sanitaire, Saint-Maurice, France.
authors.forename: L
authors.initials: L
authors.lastname: Gambotti
authors.forename: D
authors.initials: D
authors.lastname: Batisse
authors.forename: N
authors.initials: N
authors.lastname: Colin-de-Verdiere
authors.forename: E
authors.initials: E
authors.lastname: Delaroque-Astagneau
authors.forename: J C
authors.initials: JC
authors.lastname: Desenclos
authors.forename: S
authors.initials: S
authors.lastname: Dominguez
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.forename: X
authors.initials: X
authors.lastname: Duval
authors.forename: A
authors.initials: A
authors.lastname: Gervais
authors.forename: J
authors.initials: J
authors.lastname: Ghosn
authors.forename: C
authors.initials: C
authors.lastname: Larsen
authors.forename: S
authors.initials: S
authors.lastname: Pol
authors.forename: J
authors.initials: J
authors.lastname: Serpaggi
authors.forename: A
authors.initials: A
authors.lastname: Simon
authors.forename: M A
authors.initials: MA
authors.lastname: Valantin
authors.forename: A
authors.initials: A
authors.lastname: Velter
mesh_terms: D000208:Acute Disease; D000328:Adult; D015897:Comorbidity; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D019529:Sexuality / Q000706:statistics & numerical data; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology*