title: HCV reinfection incidence and spontaneous clearance rates in HIV-positive men who have sex with men in Western Europe.
abstract: Moderate cure rates of acute hepatitis C virus (HCV) infections with pegylated interferon and ribavirin have been described in the last decade in men who have sex with men (MSM), who are also coinfected with the human immunodeficiency virus (HIV). However, a subsequent high incidence of HCV reinfections has been reported regionally in men who both clear the infection spontaneously or who respond to treatment.
  
  
  
  Retrospective analysis of reinfections in HIV infected MSM in eight centers from Austria, France, Germany, and the UK within the NEAT network between May 2002 and June 2014.
  
  
  
  Of 606 individuals who cleared HCV spontaneously or were successfully treated, 149 (24.6%) presented with a subsequent HCV reinfection. Thirty out of 70 (43%) who cleared again or were successfully treated, presented with a second reinfection, 5 with a third, and one with a fourth reinfection. The reinfection incidence was 7.3/100 person-years (95% CI 6.2-8.6). We found a trend for lower incidence among individuals who had spontaneously cleared their incident infection than among individuals who were treated (Hazard ratio 0.62, 95% CI 0.38-1.02, p=0.06). Spontaneous clearance of reinfection was associated with ALT levels >1000IU/ml and spontaneous clearance of a prior infection.
  
  
  
  HCV reinfection is an issue of major concern in HIV-positive MSM. Prevention strategies are needed for high risk groups to reduce morbidity and treatment costs. HIV-positive MSM with a prior HCV infection should be tested every 3 to 6months for reinfection. Those who had achieved a reinfection should be tested every 3months.
  
  
  
  We evaluated the occurrence of HCV reinfection in HIV-positive men who have sex with men. We found an alarming incidence of 7.3/100 person-years. Prevention measures need to address this specific subgroup of patients at high risk for HCV.
authors.affiliation: Center for Infectiology (CIB), Berlin, Germany. Electronic address: ingiliz@zibp.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ingiliz
authors.affiliation: Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Martin
authors.affiliation: The Royal Free Hospital, London, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Rodger
authors.affiliation: Infectiology Center Hamburg (ICH), Hamburg, Germany.
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Stellbrink
authors.affiliation: Center for HIV and Hepatogastroenterology, Duesseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Mauss
authors.affiliation: University of Bonn, Department of Medicine I, Bonn, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Boesecke
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Mattias
authors.initials: M
authors.lastname: Mandorfer
authors.affiliation: Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Bottero
authors.affiliation: Center for Infectiology (CIB), Berlin, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Baumgarten
authors.affiliation: The Royal Free Hospital, London, United Kingdom.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Bhagani
authors.affiliation: Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.affiliation: Chelsea and Westminster Hospital, London, United Kingdom; Imperial College School of Medicine, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
authors.affiliation: University of Bonn, Department of Medicine I, Bonn, Germany.
authors.forename: Jürgen K
authors.initials: JK
authors.lastname: Rockstroh
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000453:epidemiology; D003140:Communicable Disease Control / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000453:epidemiology; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents
keywords: Acute hepatitis C; HCV reinfection; HCV therapy; HIV-HCV coinfection; SVR; Spontaneous clearance