CATIE-News: A hepatitis C outbreak among HIV-negative gay men in London, England
Some HIV-negative gay men may be at risk for getting hepatitis C. Researchers from London, England found 44 cases of acute Hep C infection in HIV-negative gay men between 2010 and 2014. Among HIV-positive gay men, hepatitis C has been rising among men who are using drugs and having sex in ways that could pass on blood infected with Hep C, such as:
- rough anal sex without a condom,
- fisting without a glove
- group sex
- serosorting – having condomless sex with partners of the same HIV status
- using drugs that can dry out mucous membranes and cause bleeding, such as crystal meth
- sharing equipment used to take drugs, such as rolled up bills
HIV-positive gay men who became Hep C positive often also had other sexually transmitted infections (STIs) – such as herpes and syphilis, which can cause sores, ulcers or lesions that can act as entry points for the Hep C virus.
To determine if hepatitis C was also an issue for HIV-negative gay men, the researchers reviewed health information collected from HIV-negative gay men at two London clinics to find out how many had Hep C and if similar types of sex and drug use were occurring among HIV-negative gay men that contracted Hep C..
Some of the findings include:
- 82% of the men were having condomless anal sex
- One-third of the men participated in group sex, fisting or sex while using drugs
- One-third of the men had an STI (gonorrhea, syphilis, chlamydia or both gonorrhea and chlamydia)
- Almost one-third were not aware of their partners’ Hep C or HIV status
The researchers were also curious if HIV-negative gay men were being screened for Hep C. They checked the records for one month and found that only 15% of HIV-negative gay men were tested for Hep C.
The researchers concluded that “acute hepatitis C is a problem for HIV-negative men who have sex with men (MSM) who have similar risks [to HIV-positive MSM]. HCV testing must be considered as a crucial part of sexual health screening in environments where risk factors or outbreaks of HCV exist.”
Sofosbuvir and ledipasvir reduced Hep C-related liver complications
The Hep C treatment combination sofosbuvir and ledipasvir decreased the incidence of serious liver damage, liver failure, liver cancer and liver transplant, reported researchers at the American Association for the Study of Liver Diseases/European Association for the Study of the Liver Special Conference on Hepatitis C.
The researchers analyzed data from 10 000 patients who had taken sofosbuvir and ledipasvir who were treatment naïve or who had been previously treated with a protease inhibitor but were not cured. The results were compared to participants who had taken:
- sofosbuvir, peg-interferon and ribavirin
- sofosbuvir and ribavirin
- simeprevir, peg-interferon and ribavirin
Sofosbuvir and ledipasvir reduced severe liver damage, liver failure, liver cancer and liver transplant by:
- 60% compared with sofosbuvir and ribavirin
- 43% compared with simeprevir, peg-interferon and ribavirin
- 17% compared with sofosbuvir, peg-interferon and ribavirin
“Ledipasvir and sofosbuvir is highly effective and has the potential to further reduce the long-term burden of HCV compared to interferon-based direct acting-antiviral (DAA) treatment, including in protease inhibitor failure patients where there is a clear unmet need for other treatment options,” the researchers concluded. (Healio.com, September 2014, in English)
Sofosbuvir and ribavirin to be tested in children and youth
A mid-stage clinical trial has started to test sofosbuvir (Sovaldi) and ribavirin in children and youth age 3 to 17 years with genotype 2 or 3 hepatitis C virus.
Until now, none of the new Hep C treatments has been tested in children. Peg-interferon and ribavirin is currently the only treatment option for children and youth.
Sofosbuvir and ribavirin will be tested for 12 weeks in children with genotype 2 hepatitis C virus and for 24 weeks for children with genotype 3 hepatitis C virus.
The study will enrol participants at 16 sites in the U.S., Germany, Italy, the U.K., Russia, Australia and New Zealand.
A future trial will test sofosbuvir and ledipasvir in children and youth with chronic hepatitis C. (HIVandhepatitis.com, September 2014, in English)