scholarly journals Development and validation of the HCV-MOSAIC risk score to assist testing for acute hepatitis C virus (HCV) infection in HIV-infected men who have sex with men (MSM)

2017 ◽  
Vol 22 (21) ◽  
Author(s):  
Astrid M Newsum ◽  
Ineke G Stolte ◽  
Jan TM van der Meer ◽  
Janke Schinkel ◽  
Marc van der Valk ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Risk Score ◽  
Risk Behaviour ◽  
Acute Hcv ◽  
Post Test ◽  
Sex With Men ◽  
Hcv Testing ◽  
Post Test Probability ◽  
Test Probability

Current guidelines recommend hepatitis C virus (HCV) testing for HIV-infected men who have sex with men (MSM) with ongoing risk behaviour, without specifying the type of risk behaviour. We developed and validated the HCV-MOSAIC risk score to assist HCV testing in HIV-infected MSM. The risk score consisted of six self-reported risk factors identified using multivariable logistic regression using data from the Dutch MOSAIC study (n = 213, 2009–2013). Area under the ROC curve (AUC), sensitivity, specificity, post-test-probability-of-disease and diagnostic gain were calculated. The risk score was validated in case–control studies from Belgium (n = 142, 2010–2013) and the United Kingdom (n = 190, 2003–2005) and in cross-sectional surveys at a Dutch sexually transmitted infections clinic (n = 284, 2007–2009). The AUC was 0.82; sensitivity 78.0% and specificity 78.6%. In the validation studies sensitivity ranged from 73.1% to 100% and specificity from 56.2% to 65.6%. The post-test-probability-of-disease ranged from 5.9% to 20.0% given acute HCV prevalence of 1.7% to 6.4%, yielding a diagnostic gain of 4.2% to 13.6%. The HCV-MOSAIC risk score can successfully identify HIV-infected MSM at risk for acute HCV infection. It could be a promising tool to improve HCV testing strategies in various settings.

scholarly journals O22.2 Detection of hepatitis c virus (hcv) in semen from hiv-infected men who have sex with men (msm) during acute hcv infection

2015 ◽  
Vol 91 (Suppl 2) ◽  
pp. A74.2-A75
Author(s):  
S Turner ◽  
M Yip ◽  
D Smith ◽  
S Weibel ◽  
W van Seggelen ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Acute Hcv ◽  
Sex With Men ◽  
Acute Hcv Infection

scholarly journals Hepatitis C Virus Treatment as Prevention: Challenges and Opportunities in Men Who Have Sex With Men

2020 ◽  
Vol 222 (Supplement_9) ◽  
pp. S782-S788
Author(s):  
Jürgen Kurt Rockstroh ◽  
Christoph Boesecke
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment As Prevention ◽  
Hcv Rna ◽  
Acute Hepatitis C ◽  
Global Epidemic ◽  
Direct Acting Antiviral ◽  
Challenges And Opportunities ◽  
Acute Hcv ◽  
Sex With Men

Abstract Since 2002, a global epidemic of acute hepatitis C virus (HCV) infection has been noted in men who have sex with men (MSM). Transmission of HCV, particularly in the context of traumatic sex practices that increase the risk of blood-blood contacts (eg, anal sex and fisting), was initially found in human immunodeficiency virus (HIV)–coinfected and more recently in HIV-uninfected MSM, especially those receiving pre-exposure prophylaxis (PrEP). Early HCV treatment with all-oral direct-acting antiviral combination therapy has been associated with very high HCV cure rates of up to 100%. Indeed, immediate treatment of recently acquired HCV directly after new HCV diagnosis, or after 4 weeks if no 2-log10 drop in HCV RNA level occurs, promises rapid HCV elimination. Reports from the Netherlands, Switzerland, and the United Kingdom all show that with increased treatment uptake in this particular patient group, dramatic reductions in new HCV infections can be achieved. A general consensus on how to best screen for and manage acute HCV infections, along with broad access to rapid HCV therapy initiation, is crucial to attaining HCV elimination, a goal that is challenged by high HCV reinfection rates among MSM.

scholarly journals Hepatitis C Virus (HCV) Antibody Dynamics Following Acute HCV Infection and Reinfection Among HIV-Infected Men Who Have Sex With Men

2014 ◽  
Vol 59 (12) ◽  
pp. 1678-1685 ◽  
Author(s):  
J. W. Vanhommerig ◽  
X. V. Thomas ◽  
J. T. M. van der Meer ◽  
R. B. Geskus ◽  
S. M. Bruisten ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Acute Hcv ◽  
Hcv Antibody ◽  
Sex With Men ◽  
Antibody Dynamics ◽  
Acute Hcv Infection

Early identification of impending cardiac arrest in neonates and infants in the cardiovascular ICU: a statistical modelling approach using physiologic monitoring data

2019 ◽  
Vol 29 (11) ◽  
pp. 1340-1348 ◽  
Author(s):  
Sanjukta N. Bose ◽  
Adam Verigan ◽  
Jade Hanson ◽  
Luis M. Ahumada ◽  
Sharon R. Ghazarian ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Risk Score ◽  
Cardiac Disease ◽  
Early Identification ◽  
Monitoring Data ◽  
Physiologic Monitoring ◽  
Post Test ◽  
Neonates And Infants ◽  
Post Test Probability ◽  
Test Probability

AbstractObjective:To develop a physiological data-driven model for early identification of impending cardiac arrest in neonates and infants with cardiac disease hospitalised in the cardiovascular ICU.Methods:We performed a single-institution retrospective cohort study (11 January 2013–16 September 2015) of patients ≤1 year old with cardiac disease who were hospitalised in the cardiovascular ICU at a tertiary care children’s hospital. Demographics and diagnostic codes of cardiac arrest were obtained via the electronic health record. Diagnosis of cardiac arrest was validated by expert clinician review. Minute-to-minute physiological monitoring data were recorded via bedside monitors. A generalized linear model was used to compute a minute by minute risk score. Training and test data sets both included data from patients who did and did not develop cardiac arrest. An optimal risk-score threshold was derived based on the model’s discriminatory capacity for impending arrest versus non-arrest. Model performance measures included sensitivity, specificity, accuracy, likelihood ratios, and post-test probability of arrest.Results:The final model consisting of multiple clinical parameters was able to identify impending cardiac arrest at least 2 hours prior to the event with an overall accuracy of 75% (sensitivity = 61%, specificity = 80%) and observed an increase in probability of detection of cardiac arrest from a pre-test probability of 9.6% to a post-test probability of 21.2%.Conclusions:Our findings demonstrate that a predictive model using physiologic monitoring data in neonates and infants with cardiac disease hospitalised in the paediatric cardiovascular ICU can identify impending cardiac arrest on average 17 hours prior to arrest.

Factors predicting first-time hepatitis C virus testing uptake among men who have sex with men in China: an observational prospective cohort study

2020 ◽  
Vol 96 (4) ◽  
pp. 258-264 ◽  
Author(s):  
Zixin Wang ◽  
Phoenix K H Mo ◽  
Yuan Fang ◽  
Mary Ip ◽  
Joseph T F Lau
Keyword(s):  
Hong Kong ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hiv Testing ◽  
Illness Representations ◽  
Testing Uptake ◽  
Sex With Men ◽  
First Time ◽  
Hcv Testing

ObjectivesMen who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong.MethodsParticipants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or shame) and coherence (overall comprehensibility of HCV). Six months later, participants reported on HCV testing uptake. Logistic regression was used to analyse the associations between baseline predictors and HCV testing uptake.ResultsMost participants were aged ≤30 years (55.0%) and had attained college education or above (85.2%). Among 242 participants (68.9%) who completed the month 6 follow-up, 12.4% had tested for HCV during the follow-up period. After adjustment for HIV testing and chemsex in the last year, participants who perceived more severe consequences of HCV reported higher HCV testing uptake (adjusted ORs (AOR): 2.22, 95% CI: 1.65 to 3.00). Belief that treatment can control HCV (AOR: 1.75, 95% CI: 1.35 to 2.26) and having negative emotions related to HCV (AOR: 1.59, 95% CI: 1.25 to 2.03) were also positively associated with HCV testing uptake.ConclusionsTargeted health promotion efforts are needed to increase HCV testing among MSM in Hong Kong. Healthcare workers engaged in HCV-related programming should consider modifying the illness representations of HCV. Integrating HCV and HIV testing services may also be beneficial.

scholarly journals 007.3 Detection of hepatitis c virus (hcv) in semen from hiv-infected men who have sex with men (msm) during acute hcv infection

2015 ◽  
Vol 91 (Suppl 2) ◽  
pp. A40.2-A41
Author(s):  
S Turner ◽  
M Yip ◽  
D Smith ◽  
S Weibel ◽  
W van Seggelen ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Acute Hcv ◽  
Sex With Men ◽  
Acute Hcv Infection

scholarly journals Comparing men who have sex with men and inject drugs and people who inject drugs who are men and have sex with men in San Francisco: Implications for HIV and hepatitis C virus prevention

2021 ◽  
Author(s):  
Adelina Artenie ◽  
Shelley N. Facente ◽  
Sheena Patel ◽  
Jack Stone ◽  
Jennifer Hecht ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
San Francisco ◽  
People Who Inject Drugs ◽  
Risk Behaviour ◽  
Behavioural Surveillance ◽  
Sociodemographic Risk ◽  
History Of ◽  
Male Sexual Partners ◽  
Sex With Men

ABSTRACTBackgroundMen who have sex with men (MSM) and people who inject drugs (PWID) carry a disproportionate burden of HIV and hepatitis C virus (HCV) infections. We compared the demographic and risk profiles of MSM who inject drugs (MSM-IDU, i.e., men reached through affiliation with MSM) and PWID who are men and have sex with men (PWID-MSM, i.e., men reached through affiliation with PWID).MethodsWe used data from the most recent waves of the National HIV Behavioural Surveillance among MSM (2017) and PWID (2018) in San Francisco. Participants were recruited through venue-based (MSM) and peer-referral (PWID) sampling and completed standardised questionnaires. We compared the characteristics of MSM-IDU and PWID-MSM using bivariate tests.ResultsOf 504 participants completing the MSM survey, 6.2% reported past-year injection drug use (MSM-IDU). Among 311 male participants completing the PWID survey, 19.0% reported past-year sex with a male (PWID-MSM). Relative to MSM-IDU, more PWID-MSM were older, identified as bisexual, had lower income, a history of incarceration and were homeless. MSM-IDU had more male sexual partners (median: 10 vs 3) and fewer injected daily (29.0% vs 64.4%) than PWID-MSM. While more PWID-MSM sought sterile equipment from a syringe program (86.4% vs 35.5%), fewer reported using PrEP (15.0% vs 42.9%).ConclusionThe sociodemographic, risk behaviour, and prevention access profiles of MSM-IDU and PWID-MSM in San Francisco suggest that they represent distinct populations who may require tailored HIV and HCV prevention strategies. MSM- and PWID-focused prevention programs should provide combined sexual health and harm reduction messages and services.

scholarly journals Hepatitis C Virus Testing Among Men With Human Immunodeficiency Virus Who Have Sex With Men: Temporal Trends and Racial/Ethnic Disparities

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Jun Li ◽  
Carl Armon ◽  
Frank J Palella ◽  
Ellen Tedaldi ◽  
Richard M Novak ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Immunodeficiency Virus ◽  
Hcv Antibody ◽  
Race Ethnicity ◽  
Sex With Men ◽  
Hcv Testing ◽  
Virus Testing

Abstract Background National guidelines recommend that sexually active people with human immunodeficiency virus (PWH) who are men who have sex with men (MSM) be tested for hepatitis C virus (HCV) infection at least annually. Hepatitis C virus testing rates vary by race/ethnicity in the general population, but limited data are available for PWH. Methods We analyzed medical records data from MSM in the HIV Outpatient Study at 9 human immunodeficiency virus (HIV) clinics from January 1, 2011 through December 31, 2019. We excluded observation time after documented past or current HCV infection. We evaluated HCV antibody testing in each calendar year among HCV-seronegative MSM, and we assessed testing correlates by generalized estimating equation analyses. Results Of 1829 eligible MSM who were PWH, 1174 (64.2%) were non-Hispanic/Latino white (NHW), 402 (22.0%) non-Hispanic black (NHB), 187 (10.2%) Hispanic/Latino, and 66 (3.6%) of other race/ethnicity. Most were ≥40 years old (68.9%), privately insured (64.5%), with CD4 cell count/mm3 (CD4) ≥350 (77.0%), and with HIV viral load <200 copies/mL (76.9%). During 2011–2019, 1205 (65.9%) had ≥1 HCV antibody test and average annual HCV percentage tested was 30.3% (from 33.8% for NHB to 28.5% for NHW; P < .001). Multivariable factors positively associated (P < .05) with HCV testing included more recent HIV diagnosis, public insurance, lower CD4, prior chlamydia, gonorrhea, syphilis, or hepatitis B virus diagnoses, and elevated liver enzyme levels, but not race/ethnicity. Conclusions Although we found no disparities by race/ethnicity in HCV testing, low overall HCV testing rates indicate suboptimal uptake of recommended HCV testing among MSM in HIV care.

scholarly journals Decline in Hepatitis C Virus (HCV) Incidence in Men Who Have Sex With Men Living With Human Immunodeficiency Virus: Progress to HCV Microelimination in the United Kingdom?

2020 ◽  
Author(s):  
Lucy J Garvey ◽  
Graham S Cooke ◽  
Colette Smith ◽  
Christoph Stingone ◽  
Indrajit Ghosh ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
United Kingdom ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Incidence Rates ◽  
World Health ◽  
Immunodeficiency Virus ◽  
Acute Hcv ◽  
Sex With Men ◽  
Living With Hiv

Abstract Background Modeling of the London hepatitis C virus (HCV) epidemic in men who have sex with men (MSM) and are living with human immunodeficiency virus (HIV) suggested that early access to direct-acting antiviral (DAA) treatment may reduce incidence. With high rates of linkage to care, microelimination of HCV within MSM living with HIV may be realistic ahead of 2030 World Health Organization targets. We examined trends in HCV incidence in the pre- and post-DAA eras for MSM living with HIV in London and Brighton, United Kingdom. Methods A retrospective cohort study was conducted at 5 HIV clinics in London and Brighton between 2013 and 2018. Each site reported all acute HCV episodes during the study period. Treatment timing data were collected. Incidence rates and reinfection proportion were calculated. Results A total of 378 acute HCV infections were identified, comprising 292 first infections and 86 reinfections. Incidence rates of acute HCV in MSM living with HIV peaked at 14.57/1000 person-years of follow-up (PYFU; 95% confidence interval [CI], 10.95–18.20) in 2015. Rates fell to 4.63/1000 PYFU (95% CI, 2.60 to 6.67) by 2018. Time from diagnosis to starting treatment declined from 29.8 (2013) to 3.7 months (2018). Conclusions We observed a 78% reduction in the incidence of first HCV episode and a 68% reduction in overall HCV incidence since the epidemic peak in 2015, which coincides with wider access to DAAs in England. Further interventions to reduce transmission, including earlier access to treatment and for reinfection, are likely needed for microelimination to be achieved in this population.

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