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Scaling up epidemics of acute hepatitis C and syphilis in HIV-infected men who have sex with men in Spain.
Sánchez, Clara; Plaza, Zulema; Vispo, Eugenia; de Mendoza, Carmen; Barreiro, Pablo; Fernández-Montero, José V; Labarga, Pablo; Poveda, Eva; Soriano, Vincent.
Afiliação
  • Sánchez C; Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
Liver Int ; 33(9): 1357-62, 2013 Oct.
Article em En | MEDLINE | ID: mdl-23730876
BACKGROUND: Outbreaks of acute hepatitis C in HIV-positive men who have sex with men (MSM) are being reported in large cities in western countries along with increasing rates of sexually transmitted diseases. METHODS: All HIV individuals attended at a large outclinic in Madrid within the last 5 years were examined. Incident syphilis was diagnosed based on rapid plasma reagin (RPR) reactivity, being negative previously or showing >4-fold increase. Acute hepatitis C was diagnosed based on HCV antibody seroconversion and/or positive serum HCV-RNA after being negative within the last year. RESULTS: A total of 859 episodes of syphilis and 19 of acute hepatitis C were diagnosed during the study period. Syphilis was recognized in 65/2,094 (3.1%) individuals attended in 2008 and rose up to 261/2,512 (10.4%) in 2012 (P < 0.001). Acute hepatitis C was diagnosed in only one subject in 2008 but rose up to 7 in 2012 (P = 0.12). All 19 HIV patients with acute hepatitis C were MSM. Syphilis was diagnosed concomitantly in seven. All eight individuals who were treated with peginterferon/ribavirin were cured, whereas only one untreated experienced spontaneous clearance (P = 0.004). Two clusters of infections by HCV genotypes 4 and 1a were identified by phylogenetic analyses. CONCLUSIONS: The incidence of acute hepatitis C is low but steadily increasing in HIV-positive MSM in Madrid (<1% yearly), despite the very high rates of syphilis (currently 20% yearly in HIV-positive MSM). Preventive measures for sexually transmitted infections and periodic HCV screening are warranted in this population as treatment of acute hepatitis C is very effective.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sífilis / Infecções por HIV / Hepatite C / Homossexualidade Masculina Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies Limite: Humans / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2013 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sífilis / Infecções por HIV / Hepatite C / Homossexualidade Masculina Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies Limite: Humans / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2013 Tipo de documento: Article