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Multiple hepatitis C virus ( HCV ) reinfections in HIV ‐positive men who have sex with men: no influence of HCV genotype switch or interleukin‐28 B genotype on spontaneous clearance
Author(s) -
Ingiliz P,
Krznaric I,
Stellbrink HJ,
Knecht G,
Lutz T,
Noah C,
Stocker H,
Obermeier M,
Dupke S,
Boesecke C,
Rockstroh JK,
Baumgarten A,
Hoffmann C
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12127
Subject(s) - medicine , genotype , men who have sex with men , hepatitis c virus , hepatitis c , virology , incidence (geometry) , immunology , human immunodeficiency virus (hiv) , gastroenterology , virus , biology , gene , biochemistry , physics , syphilis , optics
Objectives The incidence of sexually transmitted hepatitis C virus ( HCV ) reinfection is on the rise in HIV ‐infected men who have sex with men ( MSM ). Data on natural history of acute hepatitis C and possible factors associated with spontaneous clearance are limited. The aim of this study was to analyse the outcome of HCV reinfections in HIV ‐positive MSM . Methods A retrospective analysis was carried out on patients with more than one sexually acquired HCV infection who were diagnosed at four major G erman HIV and hepatitis care centres. Reinfection was defined by genotype or phylogenetic clade switch, detectable HCV RNA after a sustained virological response ( SVR ) or after spontaneous clearance ( SC ). Results In total, 48 HIV ‐positive MSM were identified with HCV reinfection, among them 11 with a third episode and one patient with four episodes. At the first episode, 43 and five patients had an SVR and SC , respectively. The second episode was accompanied by a genotype switch in 29 patients (60%). Whereas 30 and nine patients showed an SVR and SC , respectively, eight patients developed chronic hepatitis. Neither HCV genotype switch nor interleukin‐28 B genotype was associated with SC . However, SC rates at the second episode were higher for patients with SC at the first episode compared with patients without SC (60 vs. 14%, respectively; P = 0.03). Two patients with SC at the first episode were reinfected with the same genotype. Conclusions Multiple reinfections in HIV ‐infected MSM do occur, with or without genotype switch, and with prior SC of previous episodes. In this large case series, except for SC at the first episode, no factor was of value in clinical decision‐making for early therapeutic intervention in acute HCV reinfection.