Catálogo general VIH/sida
Increase of sexually transmitted hepatitis C virus in HIV+ men who have sex with men in Barcelona, Spain. A problem linked to HIV infection?
ResumenObjectives: During the last decade, outbreaks of acute hepatitis C virus (HCV) have been reported amongst men who have sex with men (MSM) across Europe. Our aim is to describe the HCV incidence from 2007 to 2013, and to analyse risk exposures amongst HCV cases in 18-59 old men in Barcelona. Methods: We calculated the incidence of new HCV cases notified to the Public Health Agency of Barcelona, 2007-2013. Demographic variables, HIV status and risk exposure, that was classified as sexual and non-sexual (e.g. undergoing surgery, invasive treatments or diagnostic tests, drug use or tattoos) were analysed. Sex orientation and other interesting variables were also collected. HCV was subtyped using a high-resolution HCV method based on massive sequencing by using 454/GS-Junior platform. Preliminar phylogenetic analyses were performed studying E2PePhD highly variable region and NS5B to assess any associations amongst cases. Results: A significant increase in HCV incidence was observed in men, from 0.65 cases/100,000 in 2007 to 4.03 in 2013, whereas a decrease for women was observed (Figure 1). During 2007-2011 amongst men aged 18-59, 22/29 (75.9%) referred having a non-sexual exposure, while in 2012-2013 34/39 (87.2%) HCV cases referred having sexual relations with other men as the only exposure. Of the identified 34 MSM HCV cases, 27 (79.4%) were HIV+. At least, 14 (37.8%) referred anonymous sex, 19 (51.4%) unprotected sex, 8 (21.6%) fisting and 8 (21.6%) having sex in private parties. 14 blood samples were analysed and two different clusters were found, for genotypes 1a and 4d. Conclusion: We detected an increase of HCV in men, the majority without other risk exposures than sexual, and many were HIV-infected patients that were being followed-up. Different genotype clusters were identified in this ongoing study, suggesting simultaneous outbreaks. Preventive measures to decrease transmission, targeted screening and improved surveillance are urgently needed.
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- Póster presentado en la HepHIV2014 Conference, celebrada en Barcelona del del 5 al 7 de octubre de 2014.