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Welcome to CATIE’s HepCInfo Update 4.8. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and newsworthy
Hepatitis C epidemic in US gay men is decades old
Hepatitis C virus transmissions have been occurring in gay men since at least the early years of the HIV epidemic, reported U.S. researchers in Clinical Infectious Diseases. Their study, based on a long-running HIV study called MACS, followed a large sample of men who have sex with men (MSM) from 1984 to 2011. All participants were uninfected with Hep C when they joined the study. The researchers found evidence of Hep C transmission from the very beginning of follow-up. Unprotected receptive anal sex and recent infection with syphilis were both risk factors for contracting hepatitis C. The majority of Hep C infections involved HIV-positive men. For these men, a lower CD4 count was significantly related to acquiring Hep C. According to the researchers, “the Hep C epidemic in both HIV-infected and -uninfected MSM has been going on for decades…these findings underscore the need for active prevention, counseling, and diagnosis of Hep C in all MSM.” (AIDSmap.com, April 2013, in English)
Adding telaprevir improves acute hepatitis C treatment for HIV-positive men
Adding telaprevir (Incivek) to peg-interferon and ribavirin shortens the duration of treatment and increases the likelihood of a cure for HIV-positive men with acute Hep C, reported researchers at the 20th Conference on Retroviruses and Opportunistic Infections in Atlanta, Georgia in March 2013. Treatment of acute Hep C improves response rates for both Hep C mono-infected and HIV/Hep C co-infected people, but co-infected people do not respond as well as those with Hep C alone. Participants in this small study were treated with telaprevir (Incivek), peg-interferon and ribavirin for 12 weeks. Standard treatment for acute hepatitis C is generally 24 weeks of peg-interferon and ribavirin. As of 4 weeks after the end of treatment, 85% (17) had cleared the virus. Clinical trials generally report the cure rate at 12 or 24 weeks after treatment completion, so researchers are following participants to determine if triple therapy with telaprevir (Incivek) will continue to suppress the Hep C virus. (HIVandhepatitis.com, March 2013, in English)
Screening program identified acute hepatitis C infection in prisoners
Screening high-risk, newly imprisoned people could identify more acute cases of hepatitis C among people who use injection drugs, according to a study published in Hepatology. Acute cases of hepatitis C are diagnosed within the first 6 months after infection. Acute cases are difficult to diagnosis because often people do not experience symptoms during this period. Researchers created a questionnaire that evaluated high-risk exposures and prior Hep C testing. For one and a half years, healthcare providers used these questions as part of intake medical evaluations at two prisons in Massachusetts. People who were identified as high risk received more in-depth counselling with a healthcare provider and laboratory testing. Approximately, 5% of inmates were identified as high risk, and 1 in 5 people in this group were subsequently found to have acute Hep C. Treating people with acute hepatitis C is easier than treating people with chronic hepatitis C because treatment lengths are shorter and cure rates are higher. According to the researchers, “this approach should also be validated in other settings where [people who use injection drugs] are frequently found, such as opiate substitution clinics, detoxification clinics and emergency departments.” (Healio.com, April 2013, in English)
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