title: Hepatitis C virus (HCV) antibody dynamics following acute HCV infection and reinfection among HIV-infected men who have sex with men.
abstract: BACKGROUND
  A decline of hepatitis C virus (HCV) antibody titers (anti-HCV), ultimately resulting in seroreversion, has been reported following clearance of viremia in both acute and chronic HCV infection. However, frequency of seroreversion remains unknown in human immunodeficiency virus (HIV)/HCV-coinfected patients. We describe anti-HCV dynamics among HIV-infected men who have sex with men (MSM) following acute HCV infection and reinfection.
  
  
  METHODS
  Primary acute HCV infection was assumed when a subject was anti-HCV negative prior to the first positive HCV RNA test. Anti-HCV was measured at least annually in 63 HIV-infected MSM, with a median follow-up of 4.0 years (interquartile range [IQR], 2.5-5.7 years). Time from HCV infection to seroconversion, and from seroconversion to seroreversion, was estimated using the Kaplan-Meier method. Longitudinal anti-HCV patterns were studied using a random-effects model to adjust for repeated measures.
  
  
  RESULTS
  Median time from HCV infection to seroconversion was 74 days (IQR, 47-125 days). Subjects who cleared HCV RNA (n = 36) showed a significant decrease in anti-HCV levels (P < .001). Among 31 subjects with sustained virologic response (SVR), anti-HCV became undetectable during follow-up in 8; cumulative incidence of seroreversion within 3 years after seroconversion was 37% (95% confidence interval, 18%-66%). Eighteen subjects became reinfected during follow-up; this coincided with a subsequent increase in anti-HCV reactivity.
  
  
  CONCLUSIONS
  A decline of anti-HCV reactivity was associated with HCV RNA clearance. Seroreversion was very common following SVR. Upon reinfection, anti-HCV levels increased again. Monitoring anti-HCV levels might therefore be an effective alternative for diagnosis of HCV reinfection.
authors.forename: Joost W
authors.initials: JW
authors.lastname: Vanhommerig
authors.forename: Xiomara V
authors.initials: XV
authors.lastname: Thomas
authors.forename: Jan T M
authors.initials: JT
authors.lastname: van der Meer
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Bruisten
authors.forename: Richard
authors.initials: R
authors.lastname: Molenkamp
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Janke
authors.initials: J
authors.lastname: Schinkel
mesh_terms: D000328:Adult; D060085:Coinfection / Q000097:blood / Q000276:immunology; D015658:HIV Infections / Q000097:blood* / Q000276:immunology*; D006526:Hepatitis C / Q000097:blood* / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D018937:Hepatitis C Antibodies
keywords: HCV reinfection; HIV/HCV coinfection; acute HCV; men who have sex with men