Gaining greater insight into HCV emergence in HIV-infected men who have sex with men: the HEPAIG Study.
OBJECTIVE
The HEPAIG study was conducted to better understand Hepatitis C virus (HCV) transmission among human immuno-deficiency (HIV)-infected men who have sex with men (MSM) and assess incidence of HCV infection among this population in France.


RESULTS
Acute HCV infection defined by anti-HCV or HCV ribonucleic acid (RNA) positivity within one year of documented anti-HCV negativity was notified among HIV-infected MSM followed up in HIV/AIDS clinics from a nationwide sampling frame. HIV and HCV infection characteristics, HCV potential exposures and sexual behaviour were collected by the physicians and via self-administered questionnaires. Phylogenetic analysis of the HCV-NS5B region was conducted. HCV incidence was 48/10 000 [95% Confidence Interval (CI):43-54] and 36/10 000 [95% CI: 30-42] in 2006 and 2007, respectively. Among the 80 men enrolled (median age: 40 years), 55% were HIV-diagnosed before 2000, 56% had at least one sexually transmitted infection in the year before HCV diagnosis; 55% were HCV-infected with genotype 4 (15 men in one 4d-cluster), 32.5% with genotype 1 (three 1a-clusters); five men were HCV re-infected; in the six-month preceding HCV diagnosis, 92% reported having casual sexual partners sought online (75.5%) and at sex venues (79%), unprotected anal sex (90%) and fisting (65%); using recreational drugs (62%) and bleeding during sex (55%).


CONCLUSIONS
This study emphasizes the role of multiple unprotected sexual practices and recreational drugs use during sex in the HCV emergence in HIV-infected MSM. It becomes essential to adapt prevention strategies and inform HIV-infected MSM with recent acute HCV infection on risk of re-infection and on risk-reduction strategies.
National Institute for Public Health Surveillance (InVS), Saint-Maurice, France. c.larsen@invs.sante.fr
Christine
C
Larsen
Marie-Laure
ML
Chaix
Yann
Y
Le Strat
Annie
A
Velter
Anne
A
Gervais
Isabelle
I
Aupérin
Laurent
L
Alric
Xavier
X
Duval
Patrick
P
Miailhes
Corinne
C
Pioche
Stanislas
S
Pol
Lionel
L
Piroth
Elisabeth
E
Delarocque-Astagneau
D000328:Adult; D001483:Base Sequence; D017931:DNA Primers; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010802:Phylogeny
D017931:DNA Primers