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High hepatitis C prevalence seen in Amsterdam PrEP study participants
Gus Cairns, 2017-02-06 09:40:00

Researchers from the Dutch PrEP demonstration study, AmPrEP, have found an unexpectedly high rate of hepatitis C (HCV)  infection in participants tested for it at baseline.

The HCV prevalence seen was more typical of HCV prevalence typically seen in HIV-positive gay men rather than the much lower rates seen in HIV-negative men.

Presenter Maria Prins said that phylogenetic mapping suggested that the explanation might lie in study participants being more likely to have condomless sex with men of HIV-positive or unknown status, amongst whom HCV prevalence was higher than other HIV-negative men.

One unanswered question is whether this might in future lead to a general increase in HCV prevalence among the HIV-negative gay population, or whether PrEP users were a specific population that were untypical of other HIV-negative gay men.

Prins said her data did suggest that hepatitis C screening and regular testing should become the norm among gay men seeking and taking PrEP. She added that if at-risk men were screened regularly and provided with early HCV treatment, the highly effective and swift-acting new HCV direct-acting antiviral (DAA) drugs would have a chance to bring about a rapid reduction in overall HCV prevalence within the gay community, by acting as hepatitis C ‘treatment as prevention’.