RESUMO
Hepatitis C virus (HCV) is not considered to be efficiently transmitted sexually, but since the early 2000s, HCV infection of HIV-infected men who have sex with men has emerged as an epidemic worldwide. In this review, we discuss the epidemiology of sexually transmitted acute HCV, the growing body of literature regarding risk factors for acquisition, and possible mechanisms of transmission. We also discuss the progression of liver disease in these men and the advances in therapy of acute HCV with interferon-free regimens and put forth our current approach of evaluating and treating these men in New York City.
Assuntos
Infecções por HIV/complicações , Hepatite C , Homossexualidade Masculina , Cirrose Hepática/etiologia , Doenças Virais Sexualmente Transmissíveis , Doença Aguda , Antivirais/uso terapêutico , Progressão da Doença , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Hepatite C/transmissão , Humanos , Cirrose Hepática/tratamento farmacológico , Masculino , Fatores de Risco , Assunção de Riscos , Comportamento Sexual , Doenças Virais Sexualmente Transmissíveis/complicações , Doenças Virais Sexualmente Transmissíveis/tratamento farmacológico , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Doenças Virais Sexualmente Transmissíveis/transmissãoAssuntos
Surtos de Doenças , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hepatite C/epidemiologia , Doença Aguda , Genótipo , Infecções por HIV/virologia , Hepacivirus/classificação , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C/diagnóstico , Hepatite C/virologia , Homossexualidade Masculina , Humanos , Masculino , Espanha/epidemiologiaRESUMO
Sexual contact is thought to be an inefficient mode of hepatitis C virus (HCV) transmission. However, reports of sexually transmitted HCV infection among HIV-infected men who have sex with men (MSM) began to appear in 2004. The patients were of early middle age with well-controlled HIV infection, participated in unprotected receptive sex, and frequently used noninjection recreational drugs. Molecular studies showed evidence of clusters of transmission between patients in different countries in Europe. Spontaneous clearance was relatively rare, but treatment with pegylated interferon and ribavirin resulted in cure in about two thirds of patients. Of concern was the finding of moderately advanced fibrosis during the early stages of HCV infection. HIV-infected MSM are a new risk group for HCV infection and so should be screened regularly for HCV infection.
RESUMO
A recent study found high levels of human immunodeficiency virus type 1 (HIV-1) bound to erythrocytes in HIV-1-infected patients with long-term undetectable plasma HIV-1 loads, potentially representing a novel and important reservoir of HIV-1 infection. To attempt to confirm this finding, we purified erythrocytes from 13 HIV-1-infected patients with long-term undetectable plasma viral load and depleted contaminating CD3(+)CD4(+) lymphocytes using magnetic beads. HIV-1 load of the purified erythrocyte fraction was <20 copies/mL in 11 of 13 patients and 42 and 52 copies/mL in 2 patients. Contrary to the prior report, therefore, erythrocytes do not represent a novel reservoir of HIV-1 infection in these patients.
