Hoornenborg Elske, Achterbergh Roel C A, Schim van der Loeff Maarten F, Davidovich Udi, Hogewoning Arjan, de Vries Henry J C, Schinkel Janke, Prins Maria, van de Laar Thijs J W
aDepartment of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam bDepartment of Infectious Diseases, Clinic for Sexually Transmitted Infections, Public Health Service of Amsterdam cDepartment of Infectious Diseases, Academic Medical Center, Center for Immunity and Infection Amsterdam (CINIMA), University of Amsterdam dDepartment of Dermatology, Academic Medical Center, Amsterdam eNational Institute of Public Health and the Environment, Center for Infectious Disease Control, Bilthoven fDepartment of Medical Microbiology, Academic Medical Center, Clinical Virology Laboratory gSanquin Research, Department of Blood-borne Infections, Amsterdam, The Netherlands. *Maria Prins and Thijs J.W. van de Laar attributed equally to the article.
AIDS. 2017 Jul 17;31(11):1603-1610. doi: 10.1097/QAD.0000000000001522.
Hepatitis C virus (HCV) has been recognized as an emerging sexually transmitted infection (STI) among HIV-positive MSM. However, HIV-negative MSM at high risk for HIV might also be at increased risk for HCV. We studied the HCV prevalence in HIV-negative MSM who start preexposure prophylaxis (PrEP) in Amsterdam. Phylogenetic analysis was used to compare HCV strains obtained from HIV-negative and HIV-positive MSM.
At enrolment in the Amsterdam PrEP demonstration project, HIV-negative MSM were tested for the presence of HCV antibodies and HCV RNA. If positive for HCV RNA, an HCV NS5B gene fragment (709 bp) was sequenced and compared with HCV isolates from HIV-positive MSM (n = 223) and risk groups other than MSM (n = 153), using phylogenetic analysis.
Of 375 HIV-negative MSM enrolled in Amsterdam PrEP, 18 (4.8%, 95% confidence interval 2.9-7.5%) of participants were anti-HCV and/or HCV RNA positive at enrolment; 15 of 18 (83%) had detectable HCV RNA. HCV genotyping showed genotype 1a (73%), 4d (20%), and 2b (7%). All HCV-positive MSM starting PrEP were part of MSM-specific HCV clusters containing MSM with and without HIV.
HCV prevalence among HIV-negative MSM who started PrEP was higher than previously reported. All HIV-negative HCV-positive MSM were infected with HCV strains already circulating among HIV-positive MSM. The increasing overlap between sexual networks of HIV-positive and HIV-negative MSM might result in an expanding HCV-epidemic irrespective of HIV-status. Hence, routine HCV testing should be offered to MSM at high risk for HIV, especially for those enrolling in PrEP programs.
丙型肝炎病毒（HCV）已被确认为HIV阳性男男性行为者（MSM）中一种新出现的性传播感染（STI）。然而，具有HIV高风险的HIV阴性MSM感染HCV的风险可能也会增加。我们研究了在阿姆斯特丹开始暴露前预防（PrEP）的HIV阴性MSM中的HCV流行情况。采用系统发育分析来比较从HIV阴性和HIV阳性MSM中获得的HCV毒株。
在阿姆斯特丹PrEP示范项目入组时，对HIV阴性MSM进行HCV抗体和HCV RNA检测。如果HCV RNA呈阳性，则对HCV NS5B基因片段（709 bp）进行测序，并使用系统发育分析将其与来自HIV阳性MSM（n = 223）和非MSM风险组（n = 153）的HCV分离株进行比较。
在阿姆斯特丹PrEP项目入组的375名HIV阴性MSM中，18名（4.8%，95%置信区间2.9 - 7.5%）参与者在入组时抗HCV和/或HCV RNA呈阳性；18名中有15名（83%）可检测到HCV RNA。HCV基因分型显示为1a型（73%）、4d型（20%）和2b型（7%）。所有开始PrEP的HCV阳性MSM都是特定于MSM的HCV簇的一部分，这些簇中包含有和没有HIV的MSM。
开始PrEP的HIV阴性MSM中的HCV流行率高于先前报道。所有HIV阴性的HCV阳性MSM都感染了已在HIV阳性MSM中传播的HCV毒株。HIV阳性和HIV阴性MSM性网络之间日益增加的重叠可能导致无论HIV状态如何，HCV流行都在扩大。因此，应向具有HIV高风险的MSM提供常规HCV检测，特别是那些参加PrEP项目的人。
