The seroprevalence of sexually transmitted HCV among men who have sex with men in Amsterdam is stabilizing, recent data show. Little is known, however, about the incidence of HCV re-infection in MSM who have cleared HCV. In the current study, the team assessed the incidence of HCV re-infection in HIV-positive MSM who were HCV RNA-negative following HCV treatment of acute primary infection.
The subjects of the Amsterdam-based study were HIV-infected MSM attending two large outpatient clinics; the men were previously diagnosed with a sexually transmitted acute HCV infection and tested HCV RNA-negative at the conclusion 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," the authors wrote. Re-infection incidence was calculated using person-time methods.
Included in the analysis were 56 persons who became HCV RNA-negative during primary acute HCV treatment. Five of these cases relapsed and were not analyzed; 11 participants were re-infected. HCV re-infection incidence in this group was 15.2 per 100 person-years (95 percent confidence interval 8.0-26.5). Cumulative incidence within two years was 33 percent.
"An alarmingly high incidence of HCV re-infection was found in this group," the authors concluded. "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.".
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