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Sexually transmitted hepatitis C infection: the new epidemic in MSM?
Daniel Bradshaw1, Gail Matthews, Mark Danta
1Viral Hepatitis and Clinical Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Purpose Of Review:
Increasing evidence has emerged for permucosal transmission of hepatitis C amongst HIV-infected MSM.
Recent Findings:
A rising incidence of acute hepatitis C virus (HCV) in HIV-infected MSM has been observed since 2000 in Europe, Australia, USA and Asia. Transmission appears to occur through the permucosal rather than the more usual parenteral route. Although often multifactorial, permucosal risk factors can be classified as behavioural (sexual practices and mucosally administered drugs) and biological (HIV and sexually transmitted infections). This review will describe the epidemiology of HCV infection in this cohort. Current and future treatment strategies will also be outlined in the context of novel, orally bioavailable, directly acting antiviral therapies.
Summary:
An improved understanding of HCV epidemiology will allow implementation of more effective public health interventions to limit onward transmission of HCV.
Insights
Hepatitis C (HCV) is increasingly transmitted via mucosal routes among HIV-infected men who have sex with men (MSM). Understanding this transmission is key to developing effective public health interventions.
Area of Science:
- Infectious Diseases
- Public Health
- Virology
Background:
- Hepatitis C virus (HCV) infection poses a growing concern among HIV-infected men who have sex with men (MSM).
- Evidence suggests a shift towards permucosal transmission routes in this population.
Purpose of the Study:
- To review the epidemiology of HCV infection in HIV-infected MSM.
- To outline current and future treatment strategies for HCV in this cohort.
Main Methods:
- Literature review focusing on studies published since 2000.
- Analysis of epidemiological data on HCV incidence and transmission routes.
- Examination of risk factors, including behavioral and biological aspects.
Main Results:
- A rising incidence of acute HCV infection has been observed in HIV-infected MSM globally since 2000.
- Permucosal transmission, involving sexual practices and mucosally administered drugs, is increasingly implicated.
- HIV and other sexually transmitted infections are identified as biological risk factors.
Conclusions:
- Enhanced understanding of HCV epidemiology in HIV-infected MSM is crucial.
- Effective public health interventions are needed to curb onward HCV transmission.
- Novel antiviral therapies offer promising treatment avenues.
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