ABSTRACT
Introduction Directly-acting antivirals (DAA) are the cornerstone to reach HCV elimination. In men who have sex with men (MSM) with HIV coinfection, recently acquired HCV infection (RAHCV) is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates. Methods The cohort included MSM with RAHCV from 2014 to 2021. The patients’ demographic, clinical, behavioral, and laboratory data were documented, as well as treatment and reinfection outcomes. Results 237 men with RAHCV were included, 216 (91%) were PLWH. Median age was 46 years (IQR: 39–52), median CD4 count was 660/mm3 (IQR: 527–835). The annual incidence of RAHCV remained between 0.28% and 0.43%, but dropped to 0.02% in 2021 during the onset of the COVID-pandemic almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95%-CI: 12.6-18.8), reinfection was associated with use of crystal methamphetamine (p=0.032) and ketamine (p=0.042). 31.3% had multiple reinfections, four reinfections occurred in PrEP users. Conclusions High treatment and cure rates did not lead to HCV elimination. A change in sexual behavior, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As RAHCV is prevalent in HIV-positive and -negative MSM, surveillance is necessary to consolidate elimination goals.
Subject(s)
COVID-19 , Coinfection , Hepatitis CABSTRACT
Background A large number of studies report COVID-19 symptom frequencies but most studies focus on hospitalized patients. Therefore reported symptom frequencies vary and their applicability to the general population is limited. Here we report COVID-19 symptom frequencies for the general population of a central European country. Methods In a collaboration between the Vienna Social Fund (FSW) and the AI-biotech company Symptoma we report symptom frequencies based on the COVID-19 chatbot of the city government of Vienna and corresponding PCR-test results. Chatbot users answered 13 yes/no questions about symptoms and provided information about age and sex. Subsequently a medically trained professional came to their address to take a sample and PCR results were obtained. Findings Between November 2 and January 5, a total of 3011 persons experiencing flu-like symptoms had a PCR-test by a medical professional at home and completed the chatbot session prior to the test, 816 (27.1%) of them were COVID-19 positive. We compared the symptom frequencies between COVID-19 positive and negative users, and between male and female users. The symptoms (sorted by frequency) of users with positive PCR-test are malaise (81.1%), fatigue (72.9%), headache (64.1%), cough (57.7%), fever (50.7%), sore throat (40.7%), close contact with COVID-19 cases (34.9%), rhinorrhea (31.0%), sneezing (28.4%), dysgeusia (27.1%), hyposmia (26.5%), dyspnea (11.4%) and diarrhea (10.9%). Among these, cough, fever, hyposmia, dysgeusia, malaise, headache, close contact with COVID-19 case and fatigue are significantly (P < 0.01) increased in COVID-19 positive persons while dyspnea, diarrhea and sore throat are significantly (P < 0.01) decreased in COVID-19 positive persons. There was no significant difference for rhinorrhea and sneezing.