New Epidemic of Sexually Transmitted Hepatitis C Infection in HIV-infected Men
in NYC
Presentation: Sunday, November 1, 2009, 8:00 am Eastern Time in Boston, MA
ALEXANDRIA, Va. and BOSTON, Oct. 30 /PRNewswire/ -- Researchers in New York
City are reporting their work uncovering a new epidemic of hepatitis C virus
(HCV) infection among men-who-have-sex-with-men (MSM) who have HIV infection.
These authors have previously reported unusually rapid fibrosis progression
due to new HCV in MSM who have HIV infection and now expand on their findings,
demonstrating that sexual transmission rather than injection drug use is the
route of infection. Treatment is highly successful if started early in the
course of infection, however, they report ominous news about liver disease
progression. "This epidemic represents a new clinical syndrome for HCV
infection that turns much of our knowledge on its ear: a new risk group
becoming infected through a previously rare route of transmission resulting in
unprecedented progression of liver fibrosis," said Daniel Fierer, MD,
principal investigator on this study.
In an analysis of 21 HCV-infected patients matched with uninfected controls,
unprotected receptive anal and oral sex were significantly associated with new
HCV infection. Neither current nor prior injection drug use was associated
with HCV infection. In addition, treatment with pegylated interferon and
ribavirin, initiated within 6 months of diagnosis, was completed in 16
patients with genotype 1 HCV infection; 12 (75%) achieved sustained viral
response (SVR), compared to the 15-30% SVR rate expected with chronic genotype
1 HCV infection. Of significant concern, however, 30 patients underwent liver
biopsy during the early infection period and 23 (77%) already had moderate
fibrosis, making early curative treatment even more important to prevent
further progression of liver fibrosis.
Because of these findings, study authors recommend routine screening for acute
HCV for all MSM patients with HIV, using a simple and inexpensive algorithm of
ALT measurement every 3 months and HCV antibody measurement every 6 to 12
months. "Changing the perception and behavior of physicians and patients is
difficult," said Dr. Fierer, "One of the main barriers to early detection is
the lack of recognition by physicians and patients alike that HIV-infected MSM
are at risk for HCV infection. This lack of perception of the problem results
in lack of screening of HIV-infected MSM and therefore lack of timely
diagnosis and treatment."
Dr. Fierer thinks the next steps in battling this epidemic are educating HIV
providers about the existence of this world-wide epidemic, educating patients
at risk that unprotected sex among HIV-infected men is a significant risk for
HCV infection, and changing the official recommendations by the US national
authorities such as the CDC, HIVMA, etc, as has already been done in Europe
and more recently at the state level in New York.
Abstract title:
Characterization of an epidemic of sexually-transmitted acute hepatitis C
infection in HIV-infected men in New York City
About the AASLD
AASLD is the leading medical society focused solely on advancing the science
and practice of hepatology and represents more than 3,300 practitioners,
researchers, and allied health professionals worldwide. Founded by physicians
in 1950, AASLD has upheld the standards of the profession and fostered
research that generates treatment options for the millions of patients with
liver diseases.
This year's Liver Meeting, held in Boston, Massachusetts, October 30 -
November 3, will bring together more than 7,000 researchers from 55 countries.
A pressroom will be available from October 31 at the annual meeting. For
copies of abstracts and press releases, or to arrange for pre-conference
research interviews contact Gregory Bologna at 703-299-9766. To pre-register,
call Ann Tracy at 703-299-9766.
Press releases, additional information for the media, and all abstracts are
available online at www.aasld.org.
Media Contact: Gregory Bologna
703/299-9766
***@****
Press Room: October 31 - November 3, 2009
Hynes Convention Center, Room 209
Telephone: (617) 954-2827
Researcher: Daniel Fierer, MD
Email: daniel.***@****
Phone: (212) 824-7413
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SOURCE American Association for the Study of Liver Diseases (AASLD)
Gregory Bologna, +1-703-299-9766, ***@****