Sexually acquired hepatitis C virus infection: a review.
Sexually acquired hepatitis C virus (HCV) infection remains a public health problem, with significant disease burden primarily in HIV-positive men who have sex with men (MSM). Over the past decades, the epidemic of sexually transmitted HCV infection has continued to expand and the epidemiology of HCV in HIV has changed significantly. In the post-combination antiretroviral therapy era, sexual network characteristics within the specific core group of MSM with increased sexual risk behaviours, including serosorting on the basis of HIV-positive status and intense mucosally traumatic sexual practices, confer increased HCV acquisition and transmission. This review summarizes the current epidemiology of sexually acquired HCV infection and the clinical and immunological contexts of acute HCV infection, and describes the biological, social, and behavioural factors that have facilitated permucosal transmission of HCV in MSM. While the advent of direct-acting antivirals has improved treatment responses significantly, sexually transmitted HCV reinfections occur in a substantial proportion of HIV-positive MSM following clearance of a primary infection. Effective strategies and preventive interventions that are tailored to the MSM communities to facilitate the control of sexually acquired HCV infection cannot be overemphasized.
Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong.
Denise P C
DP
Chan
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan.
Hsin-Yun
HY
Sun
National Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
Horas T H
HT
Wong
Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong.
Shui-Shan
SS
Lee
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan. Electronic address: hcc0401@ntu.edu.tw.
Chien-Ching
CC
Hung
D000328:Adult; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006526:Hepatitis C / Q000453:epidemiology / Q000523:psychology / Q000635:transmission* / Q000821:virology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000523:psychology / Q000635:transmission* / Q000821:virology
Combination antiretroviral therapy; Direct-acting antivirals; Men who have sex with men; Sex health; Sex network; Sexually transmitted infection; Viral hepatitis