title: Alarming incidence of hepatitis C virus re-infection after treatment of sexually acquired acute hepatitis C virus infection in HIV-infected MSM.
abstract: BACKGROUND
  Recent data indicate that seroprevalence of sexually transmitted hepatitis C virus (HCV) infection among MSM is stabilizing in Amsterdam. However, little is known about the incidence of HCV re-infection in MSM who have cleared their HCV infection. We, therefore, studied the incidence of re-infection in HIV-infected MSM who were HCV RNA-negative following HCV treatment of acute primary infection.
  
  
  METHODS
  Our study population comprised HIV-infected MSM at two large HIV outpatient clinics in Amsterdam, who were previously diagnosed with a sexually transmitted acute HCV infection and tested HCV RNA-negative at the end of treatment. We defined HCV re-infection as detectable HCV RNA in individuals with an undetectable HCV RNA at the end of treatment accompanied by a switch in HCV genotype or clade. Person-time methods were used to calculate the incidence of re-infection.
  
  
  RESULTS
  Fifty-six persons who became HCV RNA-negative during primary acute HCV treatment were included. Five of the 56 cases relapsed and were not analysed. Eleven persons were re-infected. The incidence of HCV re-infection in this group was 15.2 per 100 person-years (95% confidence interval 8.0-26.5). The cumulative incidence was 33% within 2 years.
  
  
  CONCLUSIONS
  An alarmingly high incidence of HCV re-infection was found in this group. This high re-infection rate indicates that current prevention measures should be discussed, frequent HCV RNA testing should be continued after successful treatment and, in case of possible relapse, clade typing should be performed to exclude re-infection.
authors.affiliation: Department of Research, Cluster Infectious Diseases, Public Health Service of Amsterdam, The Netherlands.
authors.forename: Femke A E
authors.initials: FA
authors.lastname: Lambers
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Xiomara
authors.initials: X
authors.lastname: Thomas
authors.forename: Richard
authors.initials: R
authors.lastname: Molenkamp
authors.forename: David
authors.initials: D
authors.lastname: Kwa
authors.forename: Kees
authors.initials: K
authors.lastname: Brinkman
authors.forename: Jan T M
authors.initials: JT
authors.lastname: van der Meer
authors.forename: Janke
authors.initials: J
authors.lastname: Schinkel
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000276:immunology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012367:RNA, Viral / Q000276:immunology; D012008:Recurrence; D016036:Seroepidemiologic Studies; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral